Differences and similarities between COVID-19 related-headache and COVID-19 vaccine related-headache. A case-control study. / Diferencias y similitudes entre la cefalea relacionada con la COVID-19 y la cefalea relacionada con la vacuna de la COVID-19. Un estudio de casos y controles.

INTRODUCTION: Headache is a frequent symptom at the acute phase of coronavirus disease 2019 (COVID-19) and also one of the most frequent adverse effects following vaccination. In both cases, headache pathophysiology seems linked to the host immune response and could have similarities. We aimed to compare the clinical phenotype and the frequency and associated onset symptoms in patients with COVID-19 related-headache and COVID-19 vaccine related-headache. SUBJECTS AND METHODS: A case-control study was conducted. Patients with confirmed COVID-19 infection and COVID-19-vaccine recipients who experienced new-onset headache were included. A standardised questionnaire was administered, including demographic variables, prior history of headaches, associated symptoms and headache-related variables. Both groups were matched for age, sex, and prior history of headache. A multivariate regression analysis was performed. RESULTS: A total of 238 patients fulfilled eligibility criteria (143 patients with COVID-19 related-headache and 95 subjects experiencing COVID-19 vaccine related-headache). Patients with COVID-19 related-headache exhibited a higher frequency of arthralgia, diarrhoea, dyspnoea, chest pain, expectoration, anosmia, myalgia, odynophagia, rhinorrhoea, cough, and dysgeusia. Further, patients with COVID-19 related-headache had a more prolonged daily duration of headache and described the headache as the worst headache ever experienced. Patients with COVID-19 vaccine-related headache, experienced more frequently pain in the parietal region, phonophobia, and worsening of the headache by head movements or eye movements. CONCLUSION: Headache caused by SARS-CoV-2 infection and COVID-19 vaccination related-headache have more similarities than differences, supporting a shared pathophysiology, and the activation of the innate immune response. The main differences were related to associated symptoms.

TITLE: Diferencias y similitudes entre la cefalea relacionada con la COVID-19 y la cefalea relacionada con la vacuna de la COVID-19. Un estudio de casos y controles.Introducción. La cefalea es un síntoma frecuente en la fase aguda de la enfermedad por coronavirus 2019 (COVID-19) y también uno de los efectos adversos más comunes tras la vacunación. En ambos casos, la fisiopatología de la cefalea parece estar relacionada con la respuesta inmunitaria del huésped y podría presentar similitudes. Nuestro objetivo fue comparar el fenotipo clínico y la frecuencia de los síntomas asociados y los síntomas de inicio en pacientes con cefalea relacionada con la COVID-19 y cefalea relacionada con la vacuna de la COVID-19. Sujetos y métodos. Se realizó un estudio de casos y controles. Se incluyó a pacientes con infección confirmada por COVID-19 y receptores de la vacuna de la COVID-19 que experimentaron un nuevo inicio de cefalea. Se administró un cuestionario estandarizado que incluyó variables demográficas, antecedentes previos de cefaleas, síntomas asociados y variables relacionadas con la cefalea. Ambos grupos se emparejaron por edad, sexo y antecedentes previos de cefaleas. Se realizó un análisis de regresión multivariante. Resultados. Un total de 238 pacientes cumplieron con los criterios de elegibilidad (143 pacientes con cefalea relacionada con la COVID-19 y 95 sujetos con cefalea relacionada con la vacuna de la COVID-19). Los pacientes con cefalea relacionada con la COVID-19 presentaron una mayor frecuencia de artralgia, diarrea, disnea, dolor torácico, expectoración, anosmia, mialgia, odinofagia, rinorrea, tos y disgeusia. Además, los pacientes con cefalea relacionada con la COVID-19 experimentaron una duración diaria más prolongada de la cefalea y describieron la cefalea como la peor que habían experimentado. Los pacientes con cefalea relacionada con la vacuna de la COVID-19 experimentaron con más frecuencia dolor en la región parietal, fonofobia y empeoramiento de la cefalea por movimientos de la cabeza o de los ojos. Conclusión. La cefalea causada por la infección por el SARS-CoV-2 y la cefalea relacionada con la vacunación de la COVID-19 presentan más similitudes que diferencias, lo que respalda una fisiopatología compartida y la activación de la respuesta inmunitaria innata. Las principales diferencias estuvieron relacionadas con los síntomas asociados.

Upgrading of solid recovered fuel (SRF) by dechlorination and catalytic pyrolysis over nanocrystalline ZSM-5 zeolite.

Globally increasing concern related to municipal solid waste generation is encouraging research efforts on developing alternative routes to valorize mixed refused wastes. In this way, catalytic pyrolysis is emerging as an interesting and efficient technology due to its great flexibility in terms of feedstock. In the current work, upgrading of a Solid Recovered Fuel (SRF) has been investigated by catalytic pyrolysis over nanocrystalline ZSM-5 zeolite (n-ZSM-5), paying special attention to dechlorination effects due to the high Cl content of the raw waste. Thus, pretreatment of the SRF by water washing and mild thermal processing allows for a significant reduction of the Cl concentration. Regarding the catalytic pyrolysis step, the best conditions correspond with a temperature of 400 °C in the catalyst bed and 0.50 catalyst/SRF mass ratio, which lead to ca. 30 wt% oil yield (rich in aromatic hydrocarbons) together with about 40 wt% gas yield (rich in C3-C4 olefins). Accordingly, these products could find use as raw chemicals or for the production of advanced fuels. In addition, zeolite reutilization has been tested for several cycles, denoting a progressive modification of the products distribution because of coke deposition. However, an almost total recovery of the n-ZSM-5 zeolite catalytic performance is achieved after regeneration by air calcination, affording the production of an oil fraction with a Cl content as low as 40 ppm.

Multiplex PCR in the empirical antibiotic treatment of patients with SARS-CoV-2 and bacterial respiratory superinfection.

Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic led to overuse of antimicrobials, which increased concerns regarding antimicrobial resistance. Objective: To measure the impact of a multiplex polymerase chain reaction (PCR) pneumonia panel on empirical antibiotic treatment for patients with critical coronavirus disease 2019 (COVID-19) with suspected bacterial respiratory superinfection. Methods: This descriptive, prospective study was undertaken in a 36-bed intensive care unit from June 2020 to July 2021. Patients with severe COVID-19 who were ventilated and under suspicion of bacterial respiratory superinfection were included in the study. The intervention was a semi-quantitative multiplex PCR alongside concurrent standard cultures. When PCR panel results were expected to be obtained within 3 h of sampling, empirical antibiotic treatment was not administered while awaiting the results. Otherwise, empirical treatment was initiated. Patients classified as 'avoided empirical treatment' avoided 48-72 h of empirical antibiotic therapy. For those patients who received empirical treatment, the PCR panel results were used to decide whether treatment should be escalated, de-escalated, maintained or stopped. Positive and negative predictive values, and 'avoided empirical treatment' were calculated. Medical conduct and panel results were analysed for patients who received empirical treatment. Results: Eighty-two patients (71% male, 29% female) were included in this study. The mean age was 57.5 years, and the mean APACHE II score was 16. Ninety PCR panels were performed, and the negative and positive predictive values were 99.9% and 66.7%, respectively. Empirical treatment was avoided in 61% of episodes. Of those patients who were receiving antibiotics when the PCR panel was performed, treatment was de-escalated in 71%, escalated in 14%, stopped in 9% and maintained in 6%. A diagnosis of bacterial respiratory superinfection was ruled out in 19% of cases. Conclusions: PCR panels prevented the initiation of empirical antibiotic treatment in two-thirds of patients, and led to de-escalation in more than two-thirds of those who had started empirical antibiotic treatment. The high negative predictive value of the PCR panel allowed the diagnosis of bacterial respiratory superinfection to be ruled out. This tool represents a significant contribution to diagnostic stewardship in order to avoid the unnecessary use of antibiotics.

Cetylpyridinium Chloride Mouthwash to Reduce Shedding of Infectious SARS-CoV-2: A Double-Blind Randomized Clinical Trial.

The airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via respiratory fluids and droplets suggests that mouthwashes containing substances with virucidal activity can help reduce viral spread. We conducted a multicenter, double-blind, placebo-controlled, randomized trial to assess the virucidal activity of cetylpyridinium chloride (CPC) mouthwashes. Outpatients who tested positive for SARS-CoV-2 infection with or without symptoms were randomized to perform washes and gargles for 1 min with 15 mL of either colored distilled water or 0.07% CPC (Vitis CPC Protect) mouthwash. The study outcomes were the SARS-CoV-2 log10 viral RNA load and the nucleocapsid protein levels, both in saliva at 1 and 3 h after the intervention. In total, 118 patients were enrolled and randomized (mean [SD], age 46 [14] y). Thirteen of 118 participants (11%) did not complete follow-up or had insufficient sample volume for testing and were excluded from the analysis. The assessment of the viral load showed no significant differences between groups at any of the investigated points. However, the levels of SARS-CoV-2 nucleocapsid protein of lysed viruses were significantly higher in the CPC group compared with the control group at 1 h (adjusted difference 269.3 pg/mL; 95% confidence interval [CI], 97.1-441.5) and at 3 h postintervention (561.1 pg/mL; 95% CI, 380.0-742.2). In nonhospitalized patients with asymptomatic or mild symptomatic SARS-CoV-2 infection, a 0.07% CPC mouthwash, compared to placebo, was associated with a significant increase of nucleocapsid protein levels in saliva, indicating enhanced disruption of viral particles.

Electrochemical genosensor for Klotho detection based on aliphatic and aromatic thiols self-assembled monolayers.

Changes in expression of Klotho gene are associated with chronic kidney disease and its potential as early biomarker is being studied. We report, for the first time, the detection of Klotho gene by a biosensor platform. Self-assembled mixed monolayers (SAMs) as DNA immobilization method in screen-printed gold electrodes and a sandwich format detection were used in the development of an electrochemical genosensor for the detection of a 100-mer DNA fragment, copy of the partial region of the mRNA Klotho gene. The use of different binary and ternary SAMs based on aliphatic (mercaptohexanol, MCH, and hexanedithiol, HDT) and aromatic (mercaptophenylacetic acid, MPAA) thiol diluents and capture probe (CP) as sensing phases was evaluated by cyclic voltammetry and electrochemical impedance spectroscopy. Multiple configurations were studied, changing the order of component addition and comparing co-immobilization and two-step immobilization processes. The procedure for binary SAM preparation consisting of sequential addition of a thiol diluent followed by CP was found to have the least detrimental impact on electrochemical performance. The signal-to-blank ratios increased considerably in the case of thioaromatic binary DNA monolayers, MPPA/CP, compared to the values obtained for aliphatic SAMs. Ternary monolayers formed by MCH and HDT rendered good fractional coverage levels and generated more reversible redox reactions at the surface, mostly when CP was firstly immobilized, CP/HDT/MCH. A significant reduction of the blank and non-specific (non-complementary sequence) signals was obtained with this ternary SAM, compared to binary SAMs and an increase of 2.42-fold of the S/B ratio (10 nM of target) compared with MPAA/CP SAMs. A linear response in the range of 5·10-10 to 5·10-8 M was obtained with CP/HDT/MCH monolayer, with a detection limit of 0.5 nM and RSD of 8.10%.

Hospital environment hygiene nurse: a key player to reduce healthcare associated infections by multi-resistant organisms.

BACKGROUND: Multi-Resistant Organisms (MRO) healthcare-associated infections (HAI) are closely associated with contamination of surfaces. Outsourced companies are usually in charge of both hospital hygiene and environmental hygiene personnel (EHP) supervision, which can result in bias. METHODS: A quasi-experimental study. The intervention was to add the "Hospital Environment Hygiene Nurse" (HEHN). MRO acquired infection rate and MRO acquired colonized rate were calculated, pre and post intervention. Confounding variables: MRO carriage rate upon admission and hospitalisation days median (HDM) were calculated. RESULTS: Median length of stay: 5 days (p=0.85, interquartile range=6 days). Carriage rate upon admission: 4.3% for pre-intervention vs 5.3% post-intervention, dif. (CI 95%): 1% (-1% to 2.9%) p=0.33. MRO acquired infection rate: 4.3% for pre-intervention vs. 2% post-intervention, Standardized Infection Ratio (SIR) (CI 95%): 0.47 (0.25 to 0.87). MRO acquired colonization rate:10.4% for pre-intervention vs. 7.9% post-intervention, SIR (CI 95%): 0.75 (0.53 to 1.07). CONCLUSIONS: As a reinforcement to standard infection control (IC) measures in place, the incorporation of an exclusive, full-time HEHN was significantly useful to reduce MRO HAI.

An Acoustic-Signal-Based Preventive Program for University Lecturers' Vocal Health.

INTRODUCTION: Professional activities of university lecturers involve continued and sustained use of the voice, leading in many cases to increased risk of developing voice disorders. Risk identification followed by the fast application of preventive or corrective measures is a key issue in this context. OBJECTIVE: Define and implement a preventive program for the vocal health of university lecturers by using acoustic features automatically extracted from voice recordings to identify risk groups and manage preventive or corrective actions MATERIAL AND METHODS: A total of 170 subjects, aged between 18 and 65, were recruited at the San Pedro de Alcántara Hospital and at the University of Extremadura in Cáceres (Spain). They formed three groups-one of 25 people suffering from vocal fold nodules, another of 25 healthy people, and the third of 120 university lecturers. Medical history and voice status assessment was performed, and voice recordings were made following a research protocol. A feature extraction, selection, and classification procedure was applied to the voice recordings to provide the best predictors for discriminating between pathological and healthy voices. The model parameters were then used to determine the lecturers' probability of suffering vocal fold nodules or other pathologies with similar dysphonic speech. These probabilities were used to classify the lecturers into three risk groups-low, medium, and high. These groups were taken as the basis to assign the lecturers to a primary, secondary, or tertiary prevention level. Different preventive or corrective actions were applied for each prevention level. RESULTS: The best set of predictors comprised sample entropy, correlation dimension, pitch period entropy, glottal noise excitation, and sex, achieving an overall accuracy of 92% with a random forest classifier. They all showed statistically significant differences between vocal fold nodules and healthy groups (P < 0.05). Three out of the four best acoustic features were nonlinear, showing the importance of nonlinear dynamics for clinical practice. The model parameters were applied to the predictors of the lecturers so as to assign them to the different risk groups, leading to 60.8% (73 out of 120) of the lecturers in the low-risk group, 29.2% (35 out of 120) in the medium-risk group, and 10% (12 out of 120) in the high-risk group. The prevention levels were assigned on the basis of this classification and the medical history and laryngological evaluation of some specific subjects. A statistically significant association was found between the voice status and the assigned prevention level (P < 0.001), with there being a clear dependence relationship (Cramér's V = 0.630). CONCLUSION: It is feasible to develop and apply a preventive voice program for university lecturers that is aided by features automatically extracted from voice recordings. As the program progresses, it is expected that the information automatically provided for the assignment to prevention levels will become ever more precise. The method proposed can be extended to other voice professionals and other voice disorders.

[Fusion biopsy. Analysis of fusion software platforms.] / Biopsias de fusión. Análisis de las plataformas de software.

Transrectal ultrasound has been a diagnostic method for diagnosis of prostate cancer for more than 30 years. It increased its options after the incorporation of MRI in the 90s. The association of real-time ultrasound with anatomical and functional data of multiparametric magnetic resonance imaging (mpMRI) has changed the prostate cancer scenario and presumably will modify the therapeutic alternatives. OBJECTIVES AND METHODS: In the following non systematic review of the literature, we present the current situation of different types of fusion biopsy, the initial preclinical and clinical results as well as the data collected in the different meta-analyses. RESULTS: Although "in bore" biopsy has shown the best sensitivity, its economic and accessibility problems make it the least widespread. Cognitive biopsy is one of the most widespread despite being the one that provides the least objective results. Fusion biopsies with Software Platform are being developed as the most reproducible and affordable in our environment. The data in the literature is still insufficient to establish what is the best software. There are many points of controversy such as number of cores, approach, associated systematic biopsies and possible connotations when assessing the therapeutic attitude. CONCLUSION: None of the Software platforms have demonstrated superiority in the diagnosis of cancer, although their results are superior to those obtained through standard and cognitive biopsy and are more affordable than the "In bore" biopsy. It is necessary to standardize the publications to be able to compare results (classification of risk in resonance, number of cores, approach). The diagnosis of cancer guided by MRI should be a factor to consider in therapeutic decision nomograms. The next challenge is the incorporation of these systems in the protocols of active surveillance and Focal Therapy.

La ecografía Transrectal (TR), método de diagnóstico del cáncer de próstata (CAP) desde hace más de 30 años, ha visto incrementadas sus opciones tras la incorporación de la resonancia en los años 90. La asociación de ecografía a tiempo real con datos anatómicos y funcionales de resonancia magnética multiparamétrica (RMmp) ha cambiado el escenario del diagnóstico de CAP y modificará las alternativas terapéuticas.OBJETIVO y MÉTODO: Con el siguiente resumen no sistemático de la literatura, se presenta la situación actual de las distintas modalidades de biopsia fusión, los resultados preclínicos y clínicos iniciales, así como los datos recogidos en los distintos meta-análisis.RESULTADOS: Si bien la Biopsia "in bore" es la que ha demostrado una mayor sensibilidad, sus inconvenientes económicos y de accesibilidad la convierten en el menos extendido. La Biopsia cognitiva es uno de los más extendidos a pesar de ser el que aportan menos resultados objetivos. Las Biopsias fusión con Plataforma Software se están incorporando en nuestro medio como las más reproducibles y asequibles. Los datos son aún insuficientes para poder establecer cuál es el mejor software. Son muchos los puntos de controversia (número de cores, vía de abordaje, biopsias sistemáticas asociadas) y las posibles connotaciones en la elección del tratamiento.CONCLUSIÓN: Ninguna de las plataformas de Software ha demostrado su superioridad si bien sus resultados son superiores a los obtenidos mediante Biopsia estándar y cognitiva y es más asequible que la biopsia "In bore". Es necesario estandarizar las publicaciones para poder comparar los resultados (clasificación de riesgo en resonancia, número de cores, abordaje). El diagnóstico de cáncer mediado por RMN deber ser un factor a tener en cuenta en los nomogramas de decisión terapéutica. El siguiente reto es la incorporación de estos sistemas en los protocolos de vigilancia activa y Terapia Focal.

Biopsias de fusión. Análisis de las plataformas de software / Fusion biopsy. Analysis of fusion software platforms

La ecografía Transrectal (TR), método de diagnóstico del cáncer de próstata (CAP) desde hace más de 30 años, ha visto incrementadas sus opciones tras la incorporación de la resonancia en los años 90. La asociación de ecografía a tiempo real con datos anatómicos y funcionales de resonancia magnética multiparamétrica (RMmp) ha cambiado el escenario del diagnóstico de CAP y modificará las alternativas terapéuticas. Objetivo y método: Con el siguiente resumen no sistemático de la literatura, se presenta la situación actual de las distintas modalidades de biopsia fusión, los resultados preclínicos y clínicos iniciales, así como los datos recogidos en los distintos meta-análisis. Resultados: Si bien la Biopsia "in bore" es la que ha demostrado una mayor sensibilidad, sus inconvenientes económicos y de accesibilidad la convierten en el menos extendido. La Biopsia cognitiva es uno de los más extendidos a pesar de ser el que aportan menos resultados objetivos. Las Biopsias fusión con Plataforma Software se están incorporando en nuestro medio como las más reproducibles y asequibles. Los datos son aún insuficientes para poder establecer cuál es el mejor software. Son muchos los puntos de controversia (número de cores, vía de abordaje, biopsias sistemáticas asociadas) y las posibles connotaciones en la elección del tratamiento. Conclusión: Ninguna de las plataformas de Software ha demostrado su superioridad si bien sus resultados son superiores a los obtenidos mediante Biopsia estándar y cognitiva y es más asequible que la biopsia "In bore". Es necesario estandarizar las publicaciones para poder comparar los resultados (clasificación de riesgo en resonancia, número de cores, abordaje). El diagnóstico de cáncer mediado por RMN deber ser un factor a tener en cuenta en los nomogramas de decisión terapéutica. El siguiente reto es la incorporación de estos sistemas en los protocolos de vigilancia activa y Terapia Focal

Transrectal ultrasound has been a diagnostic method for diagnosis of prostate cancer for more than 30 years. It increased its options after the incorporation of MRI in the 90s. The association of real-time ultrasound with anatomical and functional data of multiparametric magnetic resonance imaging (mpMRI) has changed the prostate cancer scenario and presumably will modify the therapeutic alternatives. Objectives and methods: In the following non systematic review of the literature, we present the current situation of different types of fusion biopsy, the initial preclinical and clinical results as well as the data collected in the different meta-analyses. Results: Although "in bore" biopsy has shown the best sensitivity, its economic and accessibility problems make it the least widespread. Cognitive biopsy is one of the most widespread despite being the one that provides the least objective results. Fusion biopsies with Software Platform are being developed as the most reproducible and affordable in our environment. The data in the literature is still insufficient to establish what is the best software. There are many points of controversy such as number of cores, approach, associated systematic biopsies and possible connotations when assessing the therapeutic attitude. Conclusion: None of the Software platforms have demonstrated superiority in the diagnosis of cancer, although their results are superior to those obtained through standard and cognitive biopsy and are more affordable than the "In bore" biopsy. It is necessary to standardize the publications to be able to compare results (classification of risk in resonance, number of cores, approach). The diagnosis of cancer guided by MRI should be a factor to consider in therapeutic decision nomograms. The next challenge is the incorporation of these systems in the protocols of active surveillance and Focal Therapy

Diagnostic performance of 18F-choline PET-CT in prostate cancer.

OBJECTIVES: To evaluate the diagnostic performance of 18F-choline PETCT in staging prostate cancer (PC) and whether the use of this imaging modality changes the therapeutic decision in patients previously staged by conventional imaging. The secondary aim was to determine the prognostic factors associated with positive choline PETCT findings in both detection of disseminated disease and in changes in the therapeutic indication. MATERIALS AND METHODS: Multicentre, retrospective, observational study of 269 patients diagnosed with PC. Mean age was 69 ± 9.2 years. Of the 269 patients, 62 (23%) had high-risk localized PC (group 1), 118 (43.9%) biochemical failure after radical prostatectomy (group 2), and 89 (33.1%) biochemical failure after radiotherapy (group 3). None of the patients showed clear evidence of distant disease on computed tomography or bone scans. The following potential prognostic factors were assessed: PSA level at diagnosis; primary and secondary Gleason; Gleason score (GS); clinical and pathologic T and N stage; number of positive cylinders in the biopsy; presence of vascular or lymphatic invasion; status of surgical margins; androgen deprivation therapy (ADT); time to biochemical recurrence; and PSA, PSA doubling time (PSADT), and PSA velocity (PSAV) at failure. Univariate and multivariate analyses were performed, and receiver-operating curves calculated. RESULTS: The mean PSA by groups was, group 1: 31.22 ng/ml, group 2: 2.52 ng/ml and group 3: 5.85 ng/ml. The tumor detection rate with 18F-choline PETCT was 74% (group 1: 85.5%, group 2: 55.1% and group 3: 91%). Prognostic factors for positive 18F-choline PETCT were identified only in group 2: PSA at failure and PSADT. 18F-choline PETCT changed the therapeutic indication in 62.8% (group 1: 71%, group 2: 55.2% and group 3: 70.1%). The prognostic factors for a change in treatment were identified only in group 1: secondary Gleason ≤ 4 and GS ≤ 7 and in group 2: PSA at failure, PSA nadir after surgery and pathologic stage N0. 18F-choline PETCT identified lymph node and/or metastatic disease in 32.7% (group 1: 25.8%, group 2: 29.7% and group 3: 41.6%). Prognostic factors for detecting lymph node/metastasis were identified in the group 2: PSA failure ≥ 1.37 ng/ml and PSADT < 4 months and in the group 3: PSADT < 4.6 months and time to failure < 5 years. CONCLUSION: These findings support the clinical use de 18F-choline PET-CT in staging high-risk patients with a secondary Gleason ≤ 4 and GS ≤ 7, in restaging patients with biochemical recurrence after RP if PSA at failure ≥ 1.37 ng/ml or PSADT ≤ 4 months and in patients with biochemical failure after RT, if PSADT ≤ 4.6 months and time to failure < 5 years, because it determines a change in the therapeutic indication.

Experimental and theoretical study of the collisional quenching of S(1D) by Ar.

We present an experimental and theoretical investigation of the deactivation rate of S(1D) atoms by collisions with argon. Kinetic measurements were performed at temperatures from 5.8 K to 298 K in cold uniform supersonic flows using a CRESU (Cinétique de Réaction en Ecoulement Supersonique Uniforme or Reaction Kinetics in a Uniform Supersonic Flow) apparatus. In order to simulate them, ab initio electronic structure calculations using internally contracted MRCI methodology were performed to describe the interaction. Starting from them, close-coupling calculations were carried out to determine collisional quenching probabilities for the transition S(1D) → S(3P) in the energy range 1-3000 K (1 K ≈ 0.7 cm-1), sufficient to calculate thermal rate coefficients up to 300 K. Stückelberg-like oscillations in the quenching probabilities as a function of the energy are found and interpreted using a semiclassical model. Differences between the temperature dependence of the experimental and theoretical rate coefficients are detected at low temperatures. They are discussed in the light of a study of the high sensitivity of the theoretical results to the potential curves, due to the interference mechanisms which underlie the process.

Environmental factors associated with childhood norovirus diarrhoea in León, Nicaragua.

Norovirus is detected in one in five diarrhoea episodes in children, yet little is known about environmental risk factors associated with this disease, especially in low-income settings. The objective of this study was to examine environmental risk factors, and spatial and seasonal patterns of norovirus diarrhoea episodes in children in León, Nicaragua. We followed a population-based cohort of children under age 5 years for norovirus diarrhoea over a 1-year period. At baseline, characteristics of each household were recorded. Households were geocoded and spatial locations of garbage dumps, rivers, and markets were collected. In bivariate analysis we observed younger children and those with animals in their households were more likely to have experienced norovirus episodes. In adjusted models, younger children remained at higher risk for norovirus episodes, but only modest associations were observed with family and environmental characteristics. We next identified symptomatic children living in the same household and within 500 m buffer zones around the household of another child infected with the same genotype. Norovirus diarrhoea episodes peaked early in the rainy season. These findings contribute to our understanding of environmental factors and norovirus infection.

Robot Assisted Radical Prostatectomy in Kidney Transplant Recipients. Our Clinical Experience and a Systematic Review.

INTRODUCTION: Radical prostatectomy is a more skillful procedure in kidney graft recipients. Robotic surgery can provide a useful minimally invasive tool. OBJECTIVES: The study aims to evaluate the robotic-assisted laparoscopic prostatectomy (RALP) in kidney transplant recipients, describing intra/postoperative complications, renal and oncological outcomes. METHODS: This is a retrospective study conducted in a single institution of 84 RALP. Four of them were kidney transplant recipients. Side of the renal graft, clinical stage, intra/postoperative events, operating time, creatinine levels before/after intervention and oncologic follow-up were recorded. A systematic review of the literature was performed. RESULTS: Aged 61.25 ± 7.76 years, interval between renal transplantation and RALP: 10 ± 3.16 years. Mean prostate specific antigen: 7.1 ± 2.8 ng/ml, 2 patients were cT1c and 2 cT2a. Preoperative biopsies: Gleason score 3 + 3 in 3 patients, 3 + 4 in 1 patient. Charlson comorbidity index mean was 4.82 ± 0.82. No intra/postoperative events were reported. Mean operating time: 196 ± 20.8 min. Positive surgical margins: 2/4 patients. Pathological analysis: Gleason 3 + 4 in 2 patients and Gleason 3 + 3 in the others 2. A patient developed a bladder neck sclerosis. No differences between pre/postoperative creatinine. Three patients are free of biochemical recurrence and 1 patient required adjuvant radiotherapy. CONCLUSION: RALP in renal transplant recipients is a safe and feasible technique for localized prostate cancer. No difference in oncological outcomes and no impairments on renal function were found.

Relative stabilities of HCl•H2SO4•HNO3 aggregates in polar stratospheric clouds.

Strong acids such as HCl (C), HNO3 (N) and H2SO4 (S) acquire relevance in Polar Stratospheric Clouds (PSCs) and aerosols in which nucleation processes occur. Ab initio quantum chemical studies of aggregates were performed for these strong acids. Structures were calculated using DFT methods with the B3LYP hybrid functional and aug-cc-pVTZ basis set. As an initial constraint, an H2SO4 moiety was placed in all candidate structures. A total of 11 optimized structures was found: a global minimum (CSN-a) plus ten local minima on the Potential Energy Surface (PES). The global minimum aggregate gave four hydrogen bonds, yielding a hexagonal ring in its structure. HNO3 acts as proton donor in all clusters; nevertheless, using trans-H2SO4 as the proton donor yielded the most stable structures, whereas HCl acts mainly as a proton donor/acceptor. Real harmonic frequencies, IR spectra, and inter-monomeric parameters were obtained. CSN-a symmetric stretching modes were shifted to 2805.56 cm(-1) and 3520.00 cm(-1) for H-Cl modes, while O-H modes shifted to 3256.87 cm(-1) and 3362.47 cm(-1). On the other hand, relative stabilities improved for 5 of the 11 aggregates when the temperature decreased from 298 K to 210 K, 195 K and 188 K. The aggregate CSN-f remained unstable only at 210 K. Moreover, the relative Gibbs free energy, ΔG(0-298K) was -9.26 kcalmol(-1) with respect to CSN-a; relative reaction Gibbs free energy [Δ(ΔG)] values ranged from 0.0 at 298 K, to -6.9 kcalmol(-1) at 188 K. It seems that CSN aggregates remain slightly more stable than CNS aggregates with a HNO3 moiety when the temperature decreases from 298 to 188 K. Five structures remained relatively stable under both study conditions.

Use of mTOR inhibitors in chronic heart transplant recipients with renal failure: calcineurin-inhibitors conversion or minimization?

BACKGROUND: In the last decade, mTOR inhibitors (mTOR-is) have become the cornerstone of the calcineurin inhibitor (CNI)-reduced/free regimens aimed to the preservation of post-transplant renal function. We compared utility and safety of the total replacement of calcineurin inhibitors with a mTOR-i with a strategy based on calcineurin inhibitor minimization and concomitant use of m-TOR-i. METHODS: In a retrospective multi-center cohort of 394 maintenance cardiac recipients with renal failure (GFR<60 mL/min/1.73 m(2)), we compared 235 patients in whom CNI was replaced with a mTOR-i (sirolimus or everolimus) with 159 patients in whom mTOR-is were used to minimize CNIs. A propensity score analysis was carried out to balance between group differences. RESULTS: Overall, after a median time of 2 years from mTOR-i initiation, between group differences for the evolution of renal function were not observed. In a multivariate adjusted model, improvement of renal function was limited to patients with mTOR-i usage within 5years after transplantation, particularly with the conversion strategy, and in those patients who could maintain mTOR-i therapy. Significant differences between strategies were not found for mortality, infection and mTOR-i withdrawal due to drug-related adverse events. However, conversion group tended to have a higher acute rejection incidence than the minimization group (p=0.07). CONCLUSION: In terms of renal benefits, our results support an earlier use of mTOR-is, irrespective of the strategy. The selection of either a conversion or a CNI minimization protocol should be based on the clinical characteristics of the patients, particularly their rejection risk.

Mitochondrial DNA haplogroup H as a risk factor for idiopathic dilated cardiomyopathy in Spanish population.

Idiopathic dilated cardiomyopathy (IDC) is a structural heart disease with strong genetic background. The different single nucleotide polymorphisms (SNPs) that constitute mitochondrial haplogroups could play an important role in IDC progression. The aim of this study was to test frequencies of mitochondrial haplogroups in healthy controls (n=422) and IDC patients (n=304) of a Caucasian Spanish population. To achieve this, ten major European haplogroups were identified. Frequencies and Odds Ratios for the association between IDC and haplogroups were calculated in both groups. We found that compared to healthy controls, the prevalence of haplogroup H was significantly higher in IDC patients (40.0% vs 50.7%, p-value=0.040).

Antibiotic resistance patterns of Escherichia coli isolates from different aquatic environmental sources in León, Nicaragua.

Antibiotic-resistant bacteria have emerged due to the selective pressure of antimicrobial use in humans and animals. Water plays an important role in dissemination of these organisms among humans, animals and the environment. We studied the antibiotic resistance patterns among 493 Escherichia coli isolates from different aquatic environmental sources collected from October 2008 to May 2009 in León, Nicaragua. High levels of antibiotic resistance were found in E. coli isolates in hospital sewage water and in eight of 87 well-water samples. Among the resistant isolates from the hospital sewage, ampicillin, chloramphenicol, ciprofloxacin, nalidixic acid, trimethoprim-sulphamethoxazole was the most common multi-resistance profile. Among the resistant isolates from the wells, 19% were resistant to ampicillin, ceftazidime, ceftriaxone, cefotaxime, chloramphenicol, ciprofloxacin, gentamicin, nalidixic acid and trimethoprim-sulphamethoxazole. E. coli producing ESBL and harbouring bla(CTX-M) genes were detected in one of the hospital sewage samples and in 26% of the resistant isolates from the well-water samples. The bla(CTX-M-9) group was more prevalent in E. coli isolates from the hospital sewage samples and the bla(CTX-M-1) group was more prevalent in the well-water samples.