3D-printed wound dressings containing a fosmidomycin-derivative prevent Acinetobacter baumannii biofilm formation.

Acinetobacter baumannii causes a wide range of infections, including wound infections. Multidrug-resistant A. baumannii is a major healthcare concern and the development of novel treatments against these infections is needed. Fosmidomycin is a repurposed antimalarial drug targeting the non-mevalonate pathway, and several derivatives show activity toward A. baumannii. We evaluated the antimicrobial activity of CC366, a fosmidomycin prodrug, against a collection of A. baumannii strains, using various in vitro and in vivo models; emphasis was placed on the evaluation of its anti-biofilm activity. We also developed a 3D-printed wound dressing containing CC366, using melt electrowriting technology. Minimal inhibitory concentrations of CC366 ranged from 1 to 64 µg/mL, and CC366 showed good biofilm inhibitory and moderate biofilm eradicating activity in vitro. CC366 successfully eluted from a 3D-printed dressing, the dressings prevented the formation of A. baumannnii wound biofilms in vitro and reduced A. baumannii infection in an in vivo mouse model.

3D-printed dual drug delivery nanoparticle- loaded hydrogels to combat antibiotic-resistant bacteria.

Implant-associated infections are not easy to diagnose and very difficult to treat, due to the ability of major pathogens, such as Staphylococcus aureus, to develop biofilms and escape the immune response and antibiotic treatment. We, therefore, aimed to develop a 3D-printed dual rifampicin (Rif)- and vancomycin (Van)-loaded polylactic- co-glycolic acid (PLGA) nanoparticles (NPs) delivery system based on hydrogels made of gelatin methacrylate (GelMA). The release of Rif and Van from NPs manufactured from different PLGA molecular weights was studied in phosphate-buffered saline for 21 days. Low molecular weight PLGA NPs exhibited the fastest release of Rif and Van within the first 7 days and were selected for antimicrobial evaluation. Four different GelMA-based 3D-printed samples were successfully produced, carrying non-loaded NPs, Rif-NPs, Van-NPs, or alternating layers of Rif-NPs and Van-NP. The exposition of S. aureus against increased concentrations of Rif or Van produced new resistant strains to Rif (RifR) or Van (VanR). The GelMA hydrogel co-delivering Rif and Van eradicated S. aureus RN4220 RifR and RN4220 VanR strains. S. aureus RN4220 and S. aureus AMC 201 colonies developed resistance to Rif after contact with the GelMA hydrogel containing only Rif-NPs which appeared to be due to known mutations in the rpoB gene. In conclusion, 3D-printed GelMA hydrogel loaded with PLGA Rif-Van-NPs drug delivery system show promising in vitro results to prevent implant-associated infections caused by antimicrobial-resistant bacteria.

Viabilidad y seguridad de la biopsia prostática transperineal en la era de fusión de imágenes por resonancia magnética cognitiva/ultrasonido en la detección del cáncer de próstata / Feasibility and safety of transperineal prostate biopsy in the era of cognitive magnetic resonance imaging/ultrasound fusion in prostate cancer detection

RESUMEN Objetivo : Describir los resultados de la biopsia prostática transperineal por fusión de la resonancia magnética cognitiva y ultrasonido en la detección del cáncer. Materiales y métodos : Estudio de serie de casos, retrospectivo, realizado en Clínica Delgado entre julio del 2019 y octubre del 2021. Se incluyó pacientes con examen digital de próstata y/o Antígeno Prostático Específico anormal e imágenes de Resonancia Magnética de próstata con lesiones categoría PI-RADS 4 o 5. Excluyendo a pacientes con trastorno de coagulación, lesiones rectales, imposibilidad para abducción, comorbilidades para anestesia. Registramos las características clínicas, demográficas, datos de antígeno prostático específico, volumen de la próstata, lesiones PI-RADS, tasas de cáncer, complicaciones. Resultados : Se evaluaron 18 pacientes, con edad media de 69,33 ± 7,67 años. La media del antígeno prostático específico de 14,94 ± 12,42 ng/mL. La media del volumen de próstata de 57,72 ± 28,68 cc. Al examen digital de la próstata 16/18 (88.88 %) pacientes tenían sospecha de cáncer. Se hicieron biopsias con 19 núcleos en pacientes cuya RMNmP tenían lesiones con categoría de PI-RADS 4 en 6/18 (33,33 %) de los cuales 3 resultaron positivas a Adenocarcinoma y otras 3 negativas a cáncer. Biopsia con 16 núcleos en PIRADS 5 en 12/18 (66,67 %) pacientes, resultando todas positivas a cáncer. Adenocarcinoma Acinar en 15/18 (83,33 %) con Gleason 6 en 2/18 (11,11 %) y Gleason ≥ 7 en 13/18 (72,22 %) pacientes. Complicaciones leves como hematuria 1/18 (5,6 %), disuria terminal 8/18 (44,4 %) y molestia perineal 7/18 (38,8 %) y ninguna infecciosa. Conclusiones : la biopsia prostática transperineal por fusión de imágenes de resonancia magnética cognitiva y ultrasonido es factible, segura, con tasas importantes de positividad y sin infecciones.

ABSTRACT Objective : To describe the results of transperineal prostate biopsy by fusion of cognitive magnetic resonance imaging and ultrasound in the detection of cancer. Materials and methods : A retrospective case series study conducted at the Delgado Clinic between July 2019 and October 2021. Patients with digital prostate examination and/or abnormal Prostatic Specific Antigen and prostate MRI images with category lesions were included PI-RADS 4 or 5. Excluding patients with coagulation disorders, rectal injuries, impossibility for abduction, comorbidities for anesthesia. We recorded clinical and demographic characteristics, prostate-specific antigen data, prostate volume, PI-RADS lesions, cancer rates, and complications. Results: 18 patients were evaluated, with a mean age of 69.33 ± 7.67 years. The mean prostate specific antigen was 14.94 ± 12.42 ng/mL. The mean prostate volume was 57.72 ± 28.68 cc. At the digital examination of the prostate, 16/18 (88.88%) patients had suspected cancer. Biopsies with 19 cores were performed in patients whose NMRmP had lesions with PI-RADS category 4 in 6/18 (33.33%), of which 3 were positive for Adenocarcinoma and another 3 were negative for cancer. Biopsy with 16 PIRADS 5 cores in 12/18 (66.67%) patients, all of which were positive for cancer. Acinar adenocarcinoma in 15/18 (83.33%) with Gleason 6 in 2/18 (11.11%) and Gleason ≥ 7 in 13/18 (72.22%) patients. Mild complications such as hematuria 1/18 (5.6%), terminal dysuria 8/18 (44.4%) and perineal discomfort 7/18 (38.8%) and none infectious. Conclusions : transperineal prostate biopsy by fusion of cognitive magnetic resonance imaging and ultrasound is feasible, safe, with significant positivity rates and without infections.

Radiation Oncology Residency Training in Latin America: A Call to Attention.

Purpose: Despite the call to increase the number of radiation oncologists in Latin America, the quality, similarity, and number of residency training programs are unknown. We seek to describe the current state of residency programs in radiation oncology in Latin America. Methods and Materials: Latin American Residents in Radiation Oncology performed a cross-sectional analysis of universities and training centers for radiation oncologists in Latin America. Latin American Residents in Radiation Oncology members identified and contacted current residents and specialists at each center to obtain information and documents that described their training curricula. Results: As of 2020, 13 of 23 (56.5%) Latin American countries have radiation oncology training. Seventy-three training centers were identified (59 active and 14 inactive), associated with 28 universities. On average, each active center trains 2.6 new residents per year, and in total, 156 residents are trained annually. The average length of training programs is 3.6 years. Brazil and Mexico comprise 31 (52.5%) and 7 (11.9%) of active programs, respectively, and 64 (41.8%) and 50 (32.7%) residents, respectively. Training is available in 38 cities in 13 countries, and outside Brazil and Mexico, only 13 cities in 11 countries (9 capitals and 4 noncapital cities). Individualized curriculum documents were provided by 20 (83.3%) of 24 non-Brazilian programs, while 1 standardized guideline was provided for Brazilian training programs. These demonstrated variation between subjects taught, their devoted time, outside specialty rotations, and experiences in modern techniques. Seventy-five percent include volumetric modulated arc therapy, 70% stereotactic radiosurgery, and 55% stereotactic body radiation therapy training. One-hundred percent include gynecologic brachytherapy education and <50% brachytherapy education in other disease sites. Conclusions: Training is highly centralized in capital cities. The number of trainees is insufficient to close the current human resource divide but is limited by available job openings. Over 50% of training programs now include technological training in stereotactic radiosurgery, stereotactic body radiation therapy, or volumetric modulated arc therapy; however, substantial variation still exists. The development of radiation oncology specialists must be improved and modernized to address the escalating demand for cancer care.

Screening of hepatitis C virus infection in adult general population in Spain.

PURPOSE: The aim was to estimate seroprevalence and prevalence of hepatitis C virus (HCV) infection in a small health area of the Valencian Community, Spain. PATIENTS AND METHODS: This is a descriptive cross-sectional study aimed at estimation of HCV infection prevalence in the whole adult population (25-70 years old), that is, a pilot study for an eventual population-based screening program. RESULTS: A total of 5849 participants aged 25-70 years (51% male) were invited to participate by regular mail. Overall, 143 letters were returned owing to errors in the addresses. Of 5706 participants, 2637 (46.2%) participated in the study. Rapid test of anti-HCV antibody detection was positive in 30 cases (HCV seroprevalence 1.14%, 95% confidence intervals: 0.73-1.55%). Of those, seven were not aware of their condition. Participants who had a positive result in the rapid test of anti-HCV detection were given a confirmatory test by enzyme immune assay, and all had a positive result. RNA-HCV determination by quantitative PCR in positive anti-HCV patients showed positive viremia in 13 (43.3%) cases, of which five were not aware of the disease. Of the 17 patients who had negative viremia, two were unaware of their HCV status, one was a carrier of anti-HCV and was already aware of his condition, and 14 had been previously treated with satisfactory results. Regarding fibrosis, of the seven patients who were unaware of HCV infection, none of them had significant fibrosis. Moreover, 26 (86.7%) anti-HCV positive patients were reported to have one or more risk factors for HCV infection. CONCLUSION: HCV screening strategies applied to the general population are good means to diagnose and treat patients who are not aware of their infection, avoiding new transmissions as well as disease progression.

Challenges faced in Latin America for the implementation of an ideal health-care model for rheumatoid arthritis patients: are we ready?

Rheumatoid arthritis (RA) is a chronic, inflammatory, progressive disease characterized by inflammation of the synovial tissue. It results in the severe functional deterioration of the joints involved and the incapacity to work. Our main aim is to determine the characteristics of the current health-care models used in treating rheumatoid arthritis patients in Latin America. We want to analyze the details, using them as the foundation to create an ideal health-care model that is focused on the patient. We have revised documents, including guides to clinical practice, monitoring models and health-care models according to the current policies and resources available in various Latin American countries. Based on this information, the qualities and deficiencies of the current models will be analyzed, in order to use this as a basis on which to construct a proposed health-care model that covers the specific needs of rheumatoid arthritis patients, considering the resources of each population. Despite the collapse seen in many health systems throughout history, we can learn from them and should develop a new model starting from the path pursued, capitalizing on our experiences, teachings, and errors committed. However, in most cases, the obstacles to the success of the systems do not lie in the fundamental structure or the "spirit of the legislator" but rather in the day-to-day development within the community and the special interest of each agent in a system.

Colitis eosinofílica / Eosinophilic colitis

La gastroenteritis eosinofílica es una enfermedad rara que se caracteriza por la presencia de eosinofilia hística que afecta diferentes capas de la pared intestinal por lo que desde el punto de vista histológico se clasifica en mucosa, muscular o serosa, según la capa de la pared intestinal en la que predomine el infiltrado. Puede localizarse en cualquier porción del tubo digestivo, pero excepcionalmente en el colon. Se presentó un caso de colitis eosinofílica en un paciente de 26 años de edad con síndrome diarreico crónico. Se exponen datos clínicos y estudios patológicos. Se revisó el tema...

The eosinophilic gastroenteritis is a rare disease characterized by presence of histic eosinophilia involving different layers of the intestinal wall classified from the histological point of view in mucosa, muscular or serous, according to the layer of the intestinal wall with predominance of infiltrate. It may be located in any portion of the digestive tract, but exceptionally in the colon. This the case of eosinophilic colitis in a patient aged 26 with chronic diarrheic syndrome. Clinical data and pathologic studies results are showed. This matter was reviewed...

Colitis eosinofílica / Eosinophilic colitis

La gastroenteritis eosinofílica es una enfermedad rara que se caracteriza por la presencia de eosinofilia hística que afecta diferentes capas de la pared intestinal por lo que desde el punto de vista histológico se clasifica en mucosa, muscular o serosa, según la capa de la pared intestinal en la que predomine el infiltrado. Puede localizarse en cualquier porción del tubo digestivo, pero excepcionalmente en el colon. Se presentó un caso de colitis eosinofílica en un paciente de 26 años de edad con síndrome diarreico crónico. Se exponen datos clínicos y estudios patológicos. Se revisó el tema(AU)

The eosinophilic gastroenteritis is a rare disease characterized by presence of histic eosinophilia involving different layers of the intestinal wall classified from the histological point of view in mucosa, muscular or serous, according to the layer of the intestinal wall with predominance of infiltrate. It may be located in any portion of the digestive tract, but exceptionally in the colon. This the case of eosinophilic colitis in a patient aged 26 with chronic diarrheic syndrome. Clinical data and pathologic studies results are showed. This matter was reviewed(AU)

A reagent less fluorescent sol-gel biosensor for uric acid detection in biological fluids.

The simultaneous encapsulation of a coupled uricase-peroxidase system and amplex red in a sol-gel matrix allows one to obtain a reagent-less and ready-to-use fluorescent biosensor for the accurate detection of uric acid in highly diluted biological fluids. The detection limit of the prepared biosensor was found to be 20 nM and was linear up to 1 microM. The high sensitivity found for the biosensor permitted a reliable determination of uric acid concentrations in the presence of interfering species (e.g., ascorbic acid) just by sample dilution (up to 50000 for urine and 10000 for serum and blood). The sol-gel encapsulation preserved the hierarchy of the enzyme activity as demonstrated by the performance of the fluorescent biosensor.