RESUMEN
Ninety per cent of marine organic matter burial occurs in continental margin sediments, where a substantial fraction of organic carbon escapes oxidation and enters long-term geologic storage within sedimentary rocks. In such environments, microbial metabolism is limited by the diffusive supply of electron acceptors. One strategy to optimize energy yields in a resource-limited habitat is symbiotic metabolite exchange among microbial associations. Thermodynamic and geochemical considerations indicate that microbial co-metabolisms are likely to play a critical part in sedimentary organic carbon cycling. Yet only one association, between methanotrophic archaea and sulphate-reducing bacteria, has been demonstrated in marine sediments in situ, and little is known of the role of microbial symbiotic interactions in other sedimentary biogeochemical cycles. Here we report in situ molecular and incubation-based evidence for a novel symbiotic consortium between two chemolithotrophic bacteria--anaerobic ammonium-oxidizing (anammox) bacteria and the nitrate-sequestering sulphur-oxidizing Thioploca species--in anoxic sediments of the Soledad basin at the Mexican Pacific margin. A mass balance of benthic solute fluxes and the corresponding nitrogen isotope composition of nitrate and ammonium fluxes indicate that anammox bacteria rely on Thioploca species for the supply of metabolic substrates and account for about 57 ± 21 per cent of the total benthic N2 production. We show that Thioploca-anammox symbiosis intensifies benthic fixed nitrogen losses in anoxic sediments, bypassing diffusion-imposed limitations by efficiently coupling the carbon, nitrogen and sulphur cycles.
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Bacterias/metabolismo , Sedimentos Geológicos/microbiología , Nitrógeno/metabolismo , Thiotrichaceae/metabolismo , Anaerobiosis , Bacterias/clasificación , Bacterias/genética , Carbono/metabolismo , Datos de Secuencia Molecular , Oxidación-Reducción , Océano Pacífico , Filogenia , Azufre/metabolismo , Thiotrichaceae/clasificación , Thiotrichaceae/genéticaRESUMEN
BACKGROUND: Cutaneous leishmaniasis (CL) is a disfiguring and stigmatising disease occurring in more than 70 countries across the world including Spain and Morocco. The use of sensitive tests that can differentiate Leishmania species is advised. OBJECTIVE: To evaluate the influence of the epidemiological scenario on the reliability of the PCR techniques and contribute to the selection of the most efficient one for CL diagnosis. METHODS: The sensitivities of parasitological methods and four PCRs were compared in cutaneous samples from 77 patients from Spanish (PSH) and Moroccan hospitals (PMH). Exudates and fresh or paraffin-embedded tissue biopsies were used. RESULTS: None of the PCRs used in this study allowed the diagnosis of all CL cases, showing also some drawbacks. Lmj4/Uni21-PCR displayed the best sensitivity with PMH, but it did not provide positive results in PSH with CL confirmed by other PCRs. Conversely, JW13/JW14-PCR and L. infantum-PCR-ELISA displayed good sensitivities with PSH that were not achieved with PMH. Nested-ITS-1-PCR did not show enough sensitivity with paraffin-embedded tissue biopsies. False-negative results were obtained in 19% of PSH due to unspecific hybridizations of ITS-1 primers with human chromosome1. CONCLUSIONS: PCR should be routinely used in patients with cutaneous lesions compatible with CL and furthermore, the combination of two PCR techniques is advisable. The selection of these PCRs will be influenced by the epidemiological scenario: In areas where L. infantum is endemic, the use of the PCR-ELISA joint with JW13/JW14-PCR seems an appropriate choice, whereas in areas such as Morocco, Lmj4/Uni21 and ITS-1 provide satisfactory results.
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Leishmania/patogenicidad , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/epidemiología , Reacción en Cadena de la Polimerasa/métodos , Adulto , Factores de Edad , Anciano , Estudios de Cohortes , Cartilla de ADN/genética , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Marruecos/epidemiología , Prevalencia , Estudios Retrospectivos , Medición de Riesgo , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Factores Sexuales , España/epidemiología , Adulto JovenRESUMEN
AIMS: To determine the usefulness of the fluorescence parameters generated by Sysmex UF-1000i flow cytometer for the rapid diagnosis of urinary tract infection by bacilli or cocci. METHODS AND RESULTS: Urine samples (n = 1924) were studied by culture and microbiology and subsequently by cytometry, using BACT-Morph software and considering forward-scattered light (FSC) and fluorescent light scatter fluorescence parameters. BACT-Morph software showed moderate diagnostic accuracy (78·4%) to detect rod-shaped bacteria, with sensitivity of 82·4% and specificity of 62·5%. Forward-scattered (B_FSC) values of the bacterial channel were significant higher for the Gram-positive cocci category (P < 0·001). A cut-off of B_FSC ≥24·2, expressed in arbitrary units (analytical channel, ch), provided higher sensitivity (90·0%) but lower specificity (38·9%), and the diagnostic accuracy for Gram-positive cocci classification reached 62·0%. CONCLUSIONS: Utilization of BACT-Morph software and bacterial channel fluorescence parameters (B_FSC ≥24·2 ch) offered an approximate discrimination of bacilli and cocci but the specificity was low, especially for FSC. SIGNIFICANCE AND IMPACT OF THE STUDY: Further research is needed to establish the usefulness of flow cytometry for aetiological diagnosis.
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Programas Informáticos , Urinálisis/métodos , Colorantes , Femenino , Citometría de Flujo/métodos , Fluorescencia , Humanos , Hipersensibilidad , Luz , Masculino , Sensibilidad y Especificidad , Infecciones Urinarias/microbiología , Orina/microbiologíaRESUMEN
Screening to detect latent tuberculosis infection (LTBI) is essential before patients with moderate to severe psoriasis start treatment with biologics and vigilance will continue to be needed during and after such treatment. The most recently analyzed statistics from the BIOBADADERM registry show a 20.5% prevalence of LTBI in psoriasis patients treated with biologics in Spain. Various screening protocols are in effect in different countries according to their levels of endemic TB and bacillus Calmette-Guérin (BCG) vaccination, and there is no consensus on a gold-standard approach to the diagnosis of LTBI. Tuberculin skin testing (TST) continues to be the diagnostic method of choice in spite of its limited sensitivity, mainly in immunocompromised patients. Additional problems include the TST's well-established lack of specificity, errors in application, subjectivity in the interpretation of results (which must be read during a second visit), and lack of privacy; the main advantages of this test are its low cost and ease of application. Most cost-benefit studies are therefore inclined to favor using interferon-γ release assays to detect LTBI because they minimize false positives (especially in BCG-vaccinated individuals), thereby eliminating the extra costs and side effects of unnecessary chemoprophylaxis. We review the methods used for LTBI screening in psoriasis patients who are candidates for biologic therapy. Additionally, given the fact that most guidelines do not currently consider it necessary to screen patients about to start conventional systemic therapy, we discuss the reasons underlying the need for such screening.
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Tuberculosis Latente/diagnóstico , Psoriasis/complicaciones , Terapia Biológica , Humanos , Ensayos de Liberación de Interferón gamma , España , Prueba de TuberculinaRESUMEN
BACKGROUND: The aim of this article is to assess the seroprevalence of Leishmania infection among asymptomatic renal transplant recipients in a population in the south of Spain. METHODS: Serum samples were screened for immunoglobulin-G antibodies against Leishmania with an indirect fluorescent antibody test. RESULTS: Of 625 examined serum samples, 30 (4.8%) samples were positive for Leishmania antibodies. Thirteen samples showed titers of 1:80, 15 samples showed titers of 1:160, and 2 samples showed titers of 1:320. None of the patients with positive serology to Leishmania showed signs or symptoms compatible with leishmaniasis. CONCLUSION: The prevalence of Leishmania infection found among asymptomatic renal transplant patients reinforces the need for attention in evaluation of these patients in endemic areas.
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Trasplante de Riñón/efectos adversos , Leishmaniasis/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antiprotozoarios/sangre , Niño , Femenino , Humanos , Leishmaniasis/epidemiología , Masculino , Persona de Mediana Edad , Estudios Seroepidemiológicos , España/epidemiología , Adulto JovenRESUMEN
Stewartia ovata (cav.) Weatherby, commonly known as mountain stewartia, is an understory tree native to the southeastern United States (U.S.). This relatively rare species occurs in isolated populations in Virginia, Kentucky, Tennessee, North Carolina, South Carolina, Georgia, Alabama, and Mississippi. As a species, S. ovata has largely been overlooked, and limited information is available regarding its ecology, which presents obstacles to conservation efforts. Stewartia ovata has vibrant, large white flowers that bloom in summer with a variety of filament colors, suggesting potential horticultural traits prized by ornamental industry. However, S. ovata is relatively slow growing and, due to long seed dormancy, propagation is challenging with limited success rates. This has created a need to assess the present genetic diversity in S. ovata populations to inform potential conservation and restoration of the species. Here, we employ a genotyping-by-sequencing (GBS) approach to characterize the spatial distribution and genetic diversity of S. ovata in the southern Appalachia region of the eastern United States. A total of 4475 single nucleotide polymorphisms (SNPs) were identified across 147 individuals from 11 collection sites. Our results indicate low genetic diversity (He = 0.216), the presence of population structure (K = 2), limited differentiation (F ST = 0.039), and high gene flow (Nm = 6.16) between our subpopulations. Principal component analysis corroborated the findings of STRUCTURE, confirming the presence of two distinct S. ovata subpopulations. One subpopulation mainly contains genotypes from the Cumberland Plateau, Tennessee, while the other consists of genotypes present in the Great Smoky Mountain ranges in Tennessee, North Carolina, and portions of Nantahala, Chattahoochee-Oconee national forests in Georgia, highlighting that elevation likely plays a major role in its distribution. Our results further suggested low inbreeding coefficient (F IS = 0.070), which is expected with an outcrossing tree species. This research further provides necessary insight into extant subpopulations and has generated valuable resources needed for conservation efforts of S. ovata.
RESUMEN
We evaluated the diagnostic yield of open-lung biopsies (OLBs) in a large tertiary cancer center to determine the role of infectious diseases as causes of undiagnosed pulmonary lesions. All consecutive adult patients with either single or multiple pulmonary nodules or masses who underwent a diagnostic OLB over a period of 10 years (1998-2007) were retrospectively identified. Their risk factors for malignancy and clinical and radiological characteristics were reviewed, and their postoperative complications were assessed. We evaluated 155 patients with a median age of 57 years (range, 19-83 years). We identified infectious etiologies in 29 patients (19 %). The most common diagnosis in this group was histoplasmosis (12 [41 %]), followed by nontuberculous mycobacterial infection (7 [24 %]) and aspergillosis (4 [14 %]). The majority of the 126 remaining patients had nonmalignant diagnoses, the most prevalent being nonspecific granuloma (26 %), whereas only 17 % had malignant diagnoses. We observed no significant differences among the patients with infectious, malignant, or both noninfectious and nonmalignant final diagnoses regarding their demographic, laboratory, and clinical characteristics. Six percent of the patients had at least one post-OLB complication, and the post-OLB mortality rate was 1 %. OLB is a safe diagnostic procedure which frequently identifies a wide variety of infectious and inflammatory diseases.
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Biopsia/métodos , Pruebas Diagnósticas de Rutina/métodos , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Biopsia/efectos adversos , Pruebas Diagnósticas de Rutina/efectos adversos , Femenino , Humanos , Incidencia , Pulmón/diagnóstico por imagen , Pulmón/patología , Enfermedades Pulmonares/patología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Radiografía , Estudios Retrospectivos , Centros de Atención Terciaria , Adulto JovenRESUMEN
Tuberculous otitis media (TOM) is a rare affectation in our environment that represents a challenge in its diagnosis due to the non-specific symptoms that it usually presents. This paper presents our experience in the diagnosis of a case of TOM in a 66-year-old woman with hearing loss and chronic otorrhea of more than 6 months of evolution that did not respond to conventional treatments. In addition, a review of the cases published in the last 20 years (2000-2022) in countries of the European Union (EU) is carried out. The most common symptoms were otorrhea (n=43; 100%), hearing loss (n=37; 86.05%), eardrum perforation (n=19; 44.18%), facial paralysis (n=12, 27,91%) and ear pain (n=13; 30,23%). The most used sample for diagnosis was the biopsy obtained by mastoidectomy (n=34; 79.06%). All patients were given antituberculous therapy for a mean duration of 8.11 months (range, 6-12 months). The most frequent aftereffect was hearing loss (n=28; 65.12%). TOM should be included in the differential diagnosis of chronic suppurative otitis, since early diagnosis and treatment reduce the probability of suffering irreversible sequelae.
Asunto(s)
Parálisis Facial , Otitis Media , Tuberculosis , Femenino , Humanos , Anciano , Tuberculosis/diagnóstico , Otitis Media/tratamiento farmacológico , Parálisis Facial/etiologíaRESUMEN
The purpose of this paper was to present the current knowledge on the prevention of group B streptococcus (GBS) neonatal infections and the status of prevention policies in European countries and to present the DEVANI pan-European program, launched in 2008. The aim of this program was to assess the GBS neonatal infection burden in Europe, to design a new vaccine to immunize neonates against GBS infections, to improve the laboratory performance for the diagnosis of GBS colonization and infection, and to improve the methods for the typing of GBS strains. The current guidelines for GBS prevention in different countries were ascertained and a picture of the burden before and after the instauration of prevention policies has been drawn. After the issue of the Centers for Disease Control and Prevention (CDC) guidelines, many European countries have adopted universal screening for the GBS colonization of pregnant women and intrapartum prophylaxis to colonized mothers. Nevertheless, some European countries continue advocating the risk factor approach to GBS prevention. Most European countries have implemented policies to prevent GBS neonatal infections and the burden of the disease has decreased during the last several years. Nevertheless, further steps are necessary in order to develop new strategies of prevention, to improve microbiological techniques to detect GBS colonization and infection, and to coordinate the prevention policies in the EU.
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Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/microbiología , Complicaciones Infecciosas del Embarazo/prevención & control , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/prevención & control , Streptococcus agalactiae/aislamiento & purificación , Portador Sano/epidemiología , Portador Sano/microbiología , Portador Sano/prevención & control , Europa (Continente)/epidemiología , Femenino , Política de Salud , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Prevalencia , Infecciones Estreptocócicas/epidemiología , Vacunas Estreptocócicas/inmunología , Vacunación/métodosRESUMEN
Limited ankle dorsiflexion passive range of motion (DF PROM) has been associated with lower extremity overuse injuries. Therefore, clinicians often prescribe stretching exercises to increase ankle DF PROM. However, there is limited evidence to indicate if any particular gastrocnemius stretching exercise results in greater improvement in DF PROM. The aim of this study was to determine if gastrocnemius stretching in non-weight bearing (NWB) or weight bearing (WB) results in a greater increase of ankle DF PROM. 28 healthy volunteers, aged 18-55 years, who exhibited less than 10 degrees of ankle DF PROM completed the study. Participants were randomized into 2 stretching groups: NWB and WB. Both groups completed a 3-week home gastrocnemius stretching program, consisting of 5 repetitions held for 30 s each, 2 times daily. Participants' ankle DF PROM was measured with a blinded standard goniometer in NWB and WB positions before and after participation in a 3-week home gastrocnemius stretching program. Two 3-way mixed model ANOVAs demonstrated no significant difference in ankle DF PROM between the NWB and WB groups for either the NWB measurement condition (p=0.49) or WB measurement condition (p=0.86). Gastrocnemius stretching exercises performed in NWB or WB were equally effective in increasing ankle DF PROM.
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Traumatismos en Atletas/prevención & control , Ejercicios de Estiramiento Muscular , Músculo Esquelético/fisiología , Rango del Movimiento Articular/fisiología , Soporte de Peso/fisiología , Adolescente , Adulto , Análisis de Varianza , Tobillo/fisiología , Artrometría Articular , Femenino , Humanos , Pierna/fisiología , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Sexually transmitted infections (STIs) are one of the most frequent and universal Public Health problems. Health professionals should be aware of the possibility of STIs due to their high morbidity and the presence of sequelae. The delay in the diagnosis is one of the factors that justifies the difficulty to infections control. Diagnostic tests allow the introduction of aetiological treatment and also lead to treating symptomatic and asymptomatic patients more effectively, as well as to interrupt the epidemiological transmission chain without delay. In this review we have made an update of the main existing diagnostic methods for the more important STIs.
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Enfermedades de Transmisión Sexual , Pruebas Diagnósticas de Rutina , Humanos , Enfermedades de Transmisión Sexual/diagnósticoRESUMEN
A sensitive radioimmunoassay for atrial natriuretic peptide was used to examine the relation between circulating atrial natriuretic peptide and cardiac filling pressure in normal human subjects, in patients with cardiovascular disease and normal cardiac filling pressure, and in patients with cardiovascular disease and elevated cardiac filling pressure with and without congestive heart failure. The present studies establish a normal range for atrial natriuretic peptide in normal human subjects. These studies also establish that elevated cardiac filling pressure is associated with increased circulating concentrations of atrial natriuretic peptide and that congestive heart failure is not characterized by a deficiency in atrial natriuretic peptide, but with its elevation.
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Factor Natriurético Atrial/sangre , Insuficiencia Cardíaca/sangre , Adulto , Anciano , Enfermedades Cardiovasculares/sangre , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , RadioinmunoensayoAsunto(s)
Pabellón Auricular , Enfermedades del Oído/parasitología , Leishmaniasis Cutánea , Anciano , Anciano de 80 o más Años , Enfermedades del Oído/diagnóstico , Enfermedades del Oído/tratamiento farmacológico , Femenino , Humanos , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/tratamiento farmacológico , MasculinoRESUMEN
BACKGROUND: Cytomegalovirus (CMV) is the most common viral infection after kidney transplantation and is associated with significant morbidity and mortality. Recent studies showed that CMV-specific CD8+ T cells play the crucial role in protection against CMV. The Quantiferon-CMV (QF-CMV) is an interferon gamma (IFN-γ) release assay (IGRA test) that measures the IFN-γ response to a range of T-cell epitopes of CMV. In the present study, we analyzed the clinical utility of QF-CMV assay to predict CMV infection in kidney transplant recipients and evaluated if reactive result in QF-CMV test could be predictor of the duration of treatment. METHODS: We studied 75 renal transplant recipients who had IGRA testing just before transplantation. The donor and recipient variables were reported from the clinical history. The variables related to transplantation were collected from transplantation process data and included CMV infection or disease, CMV treatment, and immunosuppressive treatment. Laboratory variables were C3-C4 complement fractions and DNA quantification of CMV. RESULTS: Fifty percent of patients had CMV infection, and 35.9% had CMV disease. The time of negativization of CMV DNA was 56.61 ± 23.5 days. Univariate analysis related to CMV infection only showed a statistically significant relation with thymoglobulin treatment (P = .001). Statistically significant variables in relation with CMV infection incidence were donor serology (P = .044) and thymoglobulin treatment (P = .004). The probability of CMV infection was lower with positive IGRA assay (P = .025). CONCLUSION: We found that IFN-γ response measured by QF-MV is a protective factor against CMV infection in post-transplantation kidney recipients.
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Infecciones por Citomegalovirus/diagnóstico , Citomegalovirus/inmunología , Ensayos de Liberación de Interferón gamma/métodos , Interferón gamma/inmunología , Complicaciones Posoperatorias/diagnóstico , Adulto , Linfocitos T CD8-positivos/virología , Citomegalovirus/genética , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/virología , ADN Viral/inmunología , Femenino , Humanos , Inmunosupresores/uso terapéutico , Incidencia , Trasplante de Riñón/efectos adversos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/virologíaRESUMEN
The clinical and microbiological characteristics of pleuro-pulmonary infection (PPI) caused by Streptococcus intermedius is described, including 6 cases in the literature and 9 cases handled at the present centre. Out of the 15 patients, 12 were male; mean age at diagnosis was 62.06 ± 15 years. Twelve had risk factors for S. intermedius infection such as alcoholism in 5 (35.7%) patients, periodontal disease in 3 (24.6%) cases, chronic obstructive pulmonary disease in 3 (24.6%), and diabetes mellitus in 2 (14.2%). Cough was present in 12 (80%) patients and chest pain and dyspnea in 9 (60%). The mean diagnosis interval was 34 days. The diagnosis was obtained from pleural fluid aspirate in 13 (86.6%) cases and from biopsy/tissue samples in 2. The most frequently antimicrobials used for treatment were ceftriaxone + levofloxacin. Ten patients cured with a combination of medical and surgical treatment and 2 patients died as a consequence of infection. The incidence of PPI caused by S. intermedius is increasing in our health area; drainage along with antibiotic therapy is recommended for treatment.
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Enfermedades Pulmonares/tratamiento farmacológico , Enfermedades Pulmonares/microbiología , Enfermedades Pleurales/tratamiento farmacológico , Enfermedades Pleurales/microbiología , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/microbiología , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/microbiología , Streptococcus intermedius , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Terapia Combinada , Femenino , Humanos , Incidencia , Enfermedades Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Enfermedades Pleurales/cirugía , Derrame Pleural/microbiología , Infecciones del Sistema Respiratorio/cirugía , Factores de Riesgo , Resultado del TratamientoRESUMEN
The metabonomic effects of hepatotoxic doses of pravastatin on the urinary metabolic profiles of female rats have been investigated using ultra performance liquid chromatography (UPLC)-oa-TOF-MS and, independently, by (1)H NMR spectroscopy. UPLC was performed using a 1 mm microbore column packed with 1.7 microm particles. Examination of the data obtained from the individual animals, aided by statistical interpretation of the data, made it possible to identify potential markers for toxicological effects, with both NMR and UPLC-MS analysis highlighting distinct changes in the urinary metabolite profiles. These markers, which included elevated taurine and creatine, as well as bile acids, were consistent with hepatotoxicity in some animals, and this hypothesis was supported by histopathological and clinical chemistry findings. The analytical data from both techniques could be used to define a metabolic "trajectory" as toxicity developed and to provide an explanation for the lack of hepatotoxicity for one of the animals. The two analytical approaches (UPLC-MS and NMR) were found to be complementary whilst the use of a 1mm i.d. x 100 mm column reduced the amount of sample required for analysis to 2 microL, compared with 10 microL for a 2.1mm i.d. x 100 mm column. The 1mm i.d. column also provided increased signal-to-noise without loss of chromatographic efficiency.
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Inhibidores de Hidroximetilglutaril-CoA Reductasas/metabolismo , Inhibidores de Hidroximetilglutaril-CoA Reductasas/orina , Pravastatina/metabolismo , Pravastatina/orina , Animales , Biomarcadores , Cromatografía Líquida de Alta Presión , Femenino , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Inyecciones Intravenosas , Espectroscopía de Resonancia Magnética , Espectrometría de Masas , Pravastatina/administración & dosificación , Ratas , Ratas WistarRESUMEN
The combination of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion can be used to improve the treatment of patients with diabetes. The aim of this study was to advance an existing preclinical single-port system for clinical application by integrating the sensors of a phosphorescence based CGM system into a standard insulin infusion set. The extracorporeal optical phase fluorimeter was miniaturised and is now comparable with commercial CGM systems regarding size, weight and wear comfort. Sensor chemistry was adapted to improve the adhesion of the sensor elements on the insulin infusion set. In-vitro tests showed a linear correlation of R2=0.998 between sensor values and reference glucose values in the range of 0-300mg/dl. Electrical and cytotoxicity tests showed no negative impact on human health. Two single-port devices were tested in each of 12 patients with type 1 diabetes mellitus in a clinical set-up for 12h. Without additional data processing, the overall median absolute relative difference (median ARD) was 22.5%. For some of the used devices the median ARD was even well below 10%. The present results show that individual glucose sensors performance of the single-port system is comparable with commercial CGM systems but further improvements are needed. The new system offers a high extent of safety and usability by combining insulin infusion and continuous glucose measurement in a single-port system which could become a central element in an artificial pancreas for an improved treatment of patients with type 1 diabetes mellitus.
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Técnicas Biosensibles/instrumentación , Automonitorización de la Glucosa Sanguínea/instrumentación , Glucemia/análisis , Diabetes Mellitus Tipo 1/sangre , Sistemas de Infusión de Insulina , Adolescente , Aspergillus niger/enzimología , Diseño de Equipo , Femenino , Fluorometría/instrumentación , Glucosa Oxidasa/química , Humanos , Masculino , Monitoreo Ambulatorio/instrumentaciónRESUMEN
OBJECTIVES: To report a case of septic arthritis due to H. parainfluenzae and to review the clinical and microbiological characteristics of published case patients. PATIENTS AND METHODS: Data was collected on age, sex, infection localization, underlying risk factors, symptom onset-diagnosis interval, analytical findings, microbiological diagnosis, treatment, outcome, and follow-up of the present patient (presenting with septic arthritis of the pubic symphysis due to H. parainfluenzae) and those identified in a literature analysis. RESULTS: Data of 18 patients, including 17 reported case patients, was collected. Mean age at presentation was 51±9 years. Underlying diseases for septic arthritis were recorded in 11 patients. The infection site was the knee in eight patients, hip and/or acromioclavicular joint in five. Pain was observed in 15 patients and fever in 10; the mean symptom onset-diagnosis interval was 9.4 days. Diagnosis was obtained from synovial fluid aspirate in 12 patients and from blood cultures in four. Susceptibility of H. parainfluenzae strains was reported in 12 cases. Eight patients were treated with cephalosporins and 10 with penicillins. A favorable outcome was observed in 13 patients. CONCLUSIONS: Septic arthritis caused by H. parainfluenzae is a rare entity that requires a high level of suspicion before application of laboratory methods for rapid diagnosis and treatment.
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Artritis Infecciosa/microbiología , Infecciones por Haemophilus/microbiología , Haemophilus parainfluenzae/aislamiento & purificación , Sínfisis Pubiana/microbiología , Antibacterianos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Artritis Infecciosa/diagnóstico por imagen , Artritis Infecciosa/tratamiento farmacológico , Susceptibilidad a Enfermedades , Quimioterapia Combinada , Femenino , Infecciones por Haemophilus/diagnóstico por imagen , Infecciones por Haemophilus/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Sínfisis Pubiana/diagnóstico por imagen , Líquido Sinovial/microbiología , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
The clinical and microbiological characteristics of infections caused by Parvimonas micra is described, including 30 cases in the literature and a new case handled at the present centre. Out of the 31 patients, 18 were male; mean age at diagnosis was 65.1 ± 13.0 years. Infection site was the vertebral spine in 14 patients and joints and heart valves in 5 each one; pain was present in all patients with articular localization and in almost all patients with vertebral involvement. The diagnosis was obtained from fluid aspirate or drainage in 13 cases and blood cultures in 11. In 8 cases, molecular techniques were also applied. The most frequently used antimicrobials were clindamycin, penicillin, amoxicillin and ceftriaxone. The outcome was positive with the medical treatment in 28 patients. P. micra infections are uncommon and requires a high index of suspicion.