Liver stiffness predicts the response to direct-acting antiviral-based therapy against chronic hepatitis C in cirrhotic patients.

The purpose of this investigation was to evaluate the impact of liver stiffness (LS) on the response to direct-acting antiviral (DAA)-based therapy against hepatitis C virus (HCV) infection in cirrhotic patients. Those patients included in two Spanish prospective cohorts of patients receiving therapy based on at least one DAA, who showed a baseline LS ≥ 12.5 kPa and who had reached the scheduled time point for sustained virological response evaluation 12 weeks after completing therapy (SVR12) were analysed. Pegylated interferon/ribavirin-based therapy plus an HCV NS3/4A protease inhibitor (PR-PI group) was administered to 198 subjects, while 146 received interferon-free regimens (IFN-free group). The numbers of patients with SVR12 according to an LS < 21 kPa versus ≥21 kPa were 59/99 (59.6%) versus 46/99 (46.5%) in the PR-PI group (p = 0.064) and 41/43 (95.3%) versus 90/103 (87.4%) in the IFN-free group (p = 0.232). Corresponding figures for the relapse rates in those who presented end-of-treatment response (ETR) were 3/62 (4.8%) versus 10/56 (17.9%, p = 0.024) and 1/42 (2.4%) versus 8/98 (8.2%, p = 0.278), respectively. In a multivariate analysis adjusted for age, sex and use of interferon, a baseline LS ≥ 21 kPa was identified as an independent predictor of relapse [adjusted odds ratio, AOR (95% confidence interval, CI): 4.228 (1.344-13.306); p = 0.014] in those patients with ETR. LS above 21 kPa is associated with higher rates of relapse to DAA-based therapy in HCV-infected patients with cirrhosis in clinical practice. LS could help us to tailor the duration and composition of DAA-based combinations in cirrhotic subjects, in order to minimise the likelihood of relapse.

[Impact of introducing an enterovirus polymerase chain reaction in the management of aseptic meningitis]. / Impacto de la implantación de la reacción en cadena de la polimerasa a enterovirus en el manejo de la meningitis aséptica.

INTRODUCTION: The diagnosis of aseptic meningitis, based on an enterovirus PCR (EV-PCR) in cerebrospinal fluid, is a rapid and sensitive test. OBJECTIVE: To assess the impact of introducing EV-PCR on the use of antibiotics and hospital length of stay in aseptic meningitis. MATERIAL AND METHODS: A prospective study that included children with aseptic meningitis during one year. The patients prior to the introduction of the test formed the control group. RESULTS: The performance of the PCR test was associated with less use of antibiotics compared to the control group (16.2% vs 41.4%, P=.029) and with fewer days of administration (.54 vs. 2 days, P=.014). A non-significant decrease in length of stay (3.57 vs. 4.21 days, P=.376) was also observed in the study group. CONCLUSION: The introduction of the EV-PCR test decreases the use of antibiotics and hospital length of stay.

[IgG antibody levels to mycobacterial antigen 60 in a healthy population of the province of Granada]. / Niveles de anticuerpos IgG frente al antígeno 60 de las micobacterias en una población sana de nuestro medio.

We have studied in the present report 86 sera from healthy individuals from Granada province with the aim of determining the serum antibody threshold level which would correlate in our media with the absence of tuberculous disease. These antibodies were detected by an ELISA method (Anda Tb) which looks for the presence of antibodies against mycobacteria 60 antigen. We establish that in our media the threshold level should be established in 200 for healthy adults and in 100 IU for healthy children.

[Changes in phagocytosis of aerobic bacteria by neutrophils after exposure to subinhibitory concentrations of aztreonam and ciprofloxacin]. / Modificación de la fagocitosis de bacterias aerobias por los neutrófilos tras la exposición a concentraciones subinhibitorias de aztreonam y ciprofloxacino.

In the present research work we are performing a study on the effect of the antibiotic concentrations low minimal inhibitory concentration of aztreonam and ciprofloxacin on phagocytosis of aerobic bacteria by neutrophils (Enterococcus faecalis, Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa). Both antibiotics induced an increased of phagocytosis by similar mechanisms. In our assay aztreonam and ciprofloxacin would not act directly on granulocyte but they would affect the bacteria increasing the opsonization and phagocytosis.