Bictegravir/Emtricitabine/Tenofovir Alafenamide in a Multicentre Cohort: Real-Life Experience From Spain.

BACKGROUND: The evaluation of bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) in clinical trials has shown high rates of virological suppression but information about its use in real-life settings is scarce. OBJECTIVE: To evaluate the effectiveness, safety, durability, and predictive variables of therapeutic failure of BIC/FTC/TAF in a real-life cohort. METHODS: This observational, retrospective, multicentered cohort study included treatment-naive (TN) and treatment-experienced (TE) adult patients living with HIV (PLWH) who started treatment with BIC/FTC/TAF from January 1, 2019, to January 31, 2022. Treatment effectiveness (based on intention-to-treat [ITT], modified ITT [mITT], and on-treatment [OT]), tolerability, and safety were evaluated in all patients who started BIC/FTC/TAF antiretroviral therapy. RESULTS: We included a total of 505 PLWH of whom 79 (16.6%) were TN and 426 (83.4%) were TE. Patients were followed up for a median (interquartile range [IQR]) of 19.6 (9.6-27.3) months, and 76% and 56% of PLWH reached month 6 and month 12 of treatment, respectively. Rates of TN PLWH with HIV-RNA <50 copies/mL in the OT, mITT, and ITT groups were 94%, 80%, and 62%, respectively, after 12 months of BIC/FTC/TAF treatment. Rates of TE PLWH with HIV-RNA <50 copies/mL were 91%, 88%, and 75% at month 12. The multivariate analysis revealed that neither age, sex, CD4 cell count <200 cells/µL, or viral load >100 000 copies/mL were associated with therapeutic failure. CONCLUSION AND RELEVANCE: Our real-life data showed that BIC/FTC/TAF is effective and safe for use in the treatment of both TN and TE patients in clinical practice.

New contributions on chronic low back pain: disc infection or contaminated cultures?

There is controversy about the likely infectious origin of chronic low back pain, because it has been suggested the possibility of a relationship with infection by Cutibacterium acnes (C. acnes). The aim of this study is to compare four methods to determine the presence of a likely infection caused by C. acnes in surgical disc samples. This work is a cross-sectional observational study in which there are included 23 patients with microdiscectomy indication. Disc samples were taken during surgery and analysis was done by culture, Sanger sequencing, next-generation sequencing (NGS), and real-time PCR (qPCR). Furthermore, clinical data collection was conducted, and it was analyzed the presence of the Modic-like changes on the magnetic resonance imaging. In 5 of the samples from among the 23 patients (21.7%), C. acnes was isolated by culture. However, in none of the samples could its genome be detected through Sanger sequencing, the less sensitive method. Only the qPCR and NGS were able to detect very few copies of the genome of this microorganism in all the samples, with no significant quantitative differences being observed between the patients in whom isolation of the microorganism by culture was evident or not. Furthermore, there were no significant relationships identified between the clinical variables, including Modic alterations and positive cultures. The most sensitive methods to the detect C. acnes were NGS and qPCR. The data obtained do not suggest association between the presence of C. acnes and the clinical process and support the hypothesis that C. acnes is found in these samples only because it is a contamination from the skin microbiome.

Mechanochromic Detection for Soft Opto-Magnetic Actuators.

New multi-stimuli responsive materials are required in smart systems applications to overcome current limitations in remote actuation and to achieve versatile operation in inaccessible environments. The incorporation of detection mechanisms to quantify in real time the response to external stimuli is crucial for the development of automated systems. Here, we present the first wireless opto-magnetic actuator with mechanochromic response. The device, based on a nanostructured-iron (Fe) layer transferred onto suspended elastomer structures with a periodically corrugated backside, can be actuated both optically (in a broadband spectral range) and magnetically. The combined opto-magnetic stimulus can accurately modulate the mechanical response (strength and direction) of the device. The structural coloration generated at the corrugated back surface enables to easily map and quantify, in 2D, the mechanical deflections by analyzing in real time the hue changes of images taken using a conventional RGB smartphone camera, with a precision of 0.05°. We demonstrate the independent and synergetic optical and magnetic actuation and detection with a detection limit of 1.8 mW·cm-2 and 0.34 mT, respectively. The simple operation, versatility, and cost-effectiveness of the wireless multiactuated device with highly sensitive mechanochromic mapping paves the way to a new generation of wirelessly controlled smart systems.

Impact of interferon-free therapies in HIV/HCV co-infected patients on real clinical practice: results from a multicenter region-wide cohort study (2014-2018).

BACKGROUND: Here, we assess the efficacy and safety of direct antiviral agents (DAAs) in a real-world cohort of co-infected individuals, and evaluate the consistency between clinical practice and guideline recommendations. METHODS: Multicenter, prospective cohort study of HIV/HCV co-infected patients followed-up in nine sites in Spain. All patients with detectable HCV-RNA naive to second-generation DAAs were enrolled. The primary endpoint was the assessment of sustained virological response at week 12 (SVR12). We performed intention-to-treat (ITT), per-protocol (PP), and multivariable analyses to identify factors associated with therapeutic failure. We compared the DAAs we administered to available guideline recommendations. Schemes not perfectly adjusted to the recommendations were defined as sub-optimal. RESULTS: Overall, 316 patients (82.1% male) received a total of 330 treatments. Of these, 43.9% were cirrhotic and 40.6% were treatment-experienced. In the ITT and PP analyses, SVR12 was achieved in 90.9% [95% confidence interval (CI) 87.3-93.6] and 93.7% (95% CI 90.5-95.6), respectively. Only alcohol abuse [odds ratio (OR): 0.33; 95% CI 0.138-0.789, P = 0.013] and a higher basal bilirubin level (OR: 0.595; 95% CI 0.416-0.851, P = 0.004) were independently associated to therapeutic failure. A progressive decrease in the proportion of sub-optimal treatments was observed over time, from 75% in 2014 to 0% in 2018. Being treated with a sub-optimal regimen was not associated with failure. CONCLUSION: Despite numerous difficulties in treatment access and in adaptation to the changing guidelines, we detected no differences among the DAAs used, nor did we detect a lower efficacy when the chosen treatment was not optimal.

In-silico drug repurposing study predicts the combination of pirfenidone and melatonin as a promising candidate therapy to reduce SARS-CoV-2 infection progression and respiratory distress caused by cytokine storm.

From January 2020, COVID-19 is spreading around the world producing serious respiratory symptoms in infected patients that in some cases can be complicated by the severe acute respiratory syndrome, sepsis and septic shock, multiorgan failure, including acute kidney injury and cardiac injury. Cost and time efficient approaches to reduce the burthen of the disease are needed. To find potential COVID-19 treatments among the whole arsenal of existing drugs, we combined system biology and artificial intelligence-based approaches. The drug combination of pirfenidone and melatonin has been identified as a candidate treatment that may contribute to reduce the virus infection. Starting from different drug targets the effect of the drugs converges on human proteins with a known role in SARS-CoV-2 infection cycle. Simultaneously, GUILDify v2.0 web server has been used as an alternative method to corroborate the effect of pirfenidone and melatonin against the infection of SARS-CoV-2. We have also predicted a potential therapeutic effect of the drug combination over the respiratory associated pathology, thus tackling at the same time two important issues in COVID-19. These evidences, together with the fact that from a medical point of view both drugs are considered safe and can be combined with the current standard of care treatments for COVID-19 makes this combination very attractive for treating patients at stage II, non-severe symptomatic patients with the presence of virus and those patients who are at risk of developing severe pulmonary complications.

Does fibrosis really regress in HIV/hepatitis C virus co-infected patients after treatment with direct antiviral agents?

OBJECTIVE: To evaluate the progression of liver stiffness after treatment with direct antiviral agents (DAAs), to identify predictive factors of fibrosis regression and to analyze the changes of scores AST-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) after treatment. DESIGN: Multicenter prospective cohort study of HIV/HCV co-infected patients conducted within the GECMEI cohort, Spain. METHODS: Individuals were eligible if they were willing to start DAAs and underwent two transient elastographies: at baseline and after the end of treatment (EOT). All patients with detectable HCV RNA naïve to DAAs were consecutively enrolled from nine medical hospitals. Liver stiffness results were categorized in four Metavir stages (F1: <7.1; F2 : 7.1--9.5; F3 : 9.5--2.4; F4: >12.4 kPa). The APRI and FIB-4 scores were calculated at baseline, EOT and 12 weeks after EOT. RESULTS: One hundred and seventy-eight patients were examined throughout a follow-up of 16.3 months (IQR: 12.5-25). The median of liver stiffness decrease was 2.6 kPa (IQR: 0-6.3). A greater improvement was observed in F3-F4 compared with F1-F2, (6.4 vs. 0.91 kPa, P < 0.001; P = 0.001, respectively). A decline between baseline and EOT measures was observed in APRI and FIB-4 (P < 0.001). Sustained virological response (SVR12) achievement was the only predictor of fibrosis regression [OR:17.4 (95% CI: 1.8-164.6; P = 0.013)]. CONCLUSION: Most patients experienced a significant reduction of liver stiffness and APRI and FIB-4 scores. This improvement was greater in those with advanced liver disease. SVR12 was the only predictor of fibrosis regression. The significance of this reduction is unclear and could reflect a decline in inflammation rather than true fibrosis regression.

Efectividad del tratamiento con agentes antivirales directos en pacientes con coinfección por VHC y VIH. Estudio de cohorte multicéntrico / Effectiveness of direct-acting antiviral therapy in patients with a HCV/HIV coinfection. A multicenter cohort study

Introducción: la eficacia de los agentes antivirales directos (AAD) ha quedado demostrada en ensayos clínicos tanto en mono como en coinfectados. Nuestro objetivo es analizar la efectividad y toxicidad de este tratamiento en vida real en pacientes con coinfección por VIH y VHC así como determinar variables asociadas a una evolución desfavorable. Métodos: estudio ambispectivo multicéntrico en una cohorte de pacientes coinfectados. Los datos fueron recogidos en ocho centros de Castilla-La Mancha entre 2014 y 2016. Se realizó un análisis por intención de tratamiento en el que cualquier pérdida de seguimiento, abandono de tratamiento o toxicidad terapéutica se consideró fracaso. Resultados: se estudiaron 229 pacientes con una mediana de edad de 49,6 años con predominio masculino (83%). Menos de un 10% presentaba carga viral (CV) detectable para el VIH. El genotipo de VHC más prevalente fue el 1 (65,1%). Un 50% tenía hepatopatía en grado de cirrosis. El 65% presentaba más de 800.000 copias/ml de CV de VHC. La respuesta viral sostenida (RVS) se alcanzó globalmente en el 91,7%. La estrategia de AAD más utilizada fue sofosbuvir/ ledipasvir. Un 52% de las pautas incluyeron ribavirina. El 65,9% completó pautas de 12 semanas y un 30%, de 24 semanas. Hubo 19 fracasos terapéuticos. No existen diferencias entre las distintas estrategias de AAD utilizadas. No se observó ningún factor predictor independiente de RVS. Conclusiones: el tratamiento del VHC en pacientes coinfectados presenta tasas de RVS muy elevadas también en vida real. La toxicidad es excepcional. No hemos identificado factores predictores específicos de evolución desfavorable (AU)

ntroduction: The effectiveness of direct-acting antiviral (DAA) agents has been demonstrated in clinical trials both in patients with mono and coinfections. The goal of the study was to analyze the effectiveness and toxicity of this therapy in real-life patients with a HIV/HCV coinfection and to identify variables that are associated with an unfavorable outcome. Methods: This was a multicenter ambispective study in a cohort of coinfected patients. Data were collected from eight centers in Castilla-La Mancha from 2014 to 2016. An intent-to-treat analysis was performed and any loss to follow-up, treatment withdrawal or toxicity was considered as a failure. Results: A total of 229 patients were included with a median age of 49.6 years and the majority were male (83%). Fewer than 10% had a detectable HIV-related viral load (VL). The most prevalent HCV genotype was 1 (65.1%). Fifty percent had cirrhotic liver disease and 65% had over 800,000 copies/ml of HCV VL. The global sustained viral response (SVR) was reached by 91.7% of cases. The most commonly used DAA regimen was sofosbuvir/ledipasvir. Ribavirin was included in 52% of regimens, 65.9% of cases completed 12-week regimens and 30% completed 24-week schemes. There were 19 therapy failures. No differences were observed between the various DAA strategies used. No independent predictor was found for SVR. Conclusions: HCV treatment in coinfected patients is highly successful in terms of SVR rate in the real-life setting and toxicity is exceptional. We identified no specific predictors of an unfavorable outcome (AU)

Effectiveness of direct-acting antiviral therapy in patients with a HCV/HIV coinfection. A multicenter cohort study.

INTRODUCTION: The effectiveness of direct-acting antiviral (DAA) agents has been demonstrated in clinical trials both in patients with mono and coinfections. The goal of the study was to analyze the effectiveness and toxicity of this therapy in real-life patients with a HIV/HCV coinfection and to identify variables that are associated with an unfavorable outcome. METHODS: This was a multicenter ambispective study in a cohort of coinfected patients. Data were collected from eight centers in Castilla-La Mancha from 2014 to 2016. An intent-to-treat analysis was performed and any loss to follow-up, treatment withdrawal or toxicity was considered as a failure. RESULTS: A total of 229 patients were included with a median age of 49.6 years and the majority were male (83%). Fewer than 10% had a detectable HIV-related viral load (VL). The most prevalent HCV genotype was 1 (65.1%). Fifty percent had cirrhotic liver disease and 65% had over 800,000 copies/ml of HCV VL. The global sustained viral response (SVR) was reached by 91.7% of cases. The most commonly used DAA regimen was sofosbuvir/ledipasvir. Ribavirin was included in 52% of regimens, 65.9% of cases completed 12-week regimens and 30% completed 24-week schemes. There were 19 therapy failures. No differences were observed between the various DAA strategies used. No independent predictor was found for SVR. CONCLUSIONS: HCV treatment in coinfected patients is highly successful in terms of SVR rate in the real-life setting and toxicity is exceptional. We identified no specific predictors of an unfavorable outcome.

Diagnosis features of pediatric Gaucher disease patients in the era of enzymatic therapy, a national-base study from the Spanish Registry of Gaucher Disease.

BACKGROUND: The enzymatic replacement therapy (ERT) availability for Gaucher disease (GD) has changed the landscape of the disease, several countries have screening programs. These actions have promoted the early diagnosis and avoided many complications in pediatric patients. In Spain ERT has been available since 1993 and 386 patients have been included in the Spanish Registry of Gaucher Disease (SpRGD). The aim of this study is to analyze the impact of ERT on the characteristics at time of diagnosis and initial complications in pediatric Gaucher disease patients. AIM: To analyze the impact of ERT on the characteristics at time of diagnosis and initial complications in pediatric Gaucher disease patients. METHODS: A review of data in SpRGD from patients' diagnosed before 18 years old was performed. The cohort was split according the year of diagnosis (≤1994, cohort A; ≥1995, cohort B). RESULTS: A total of 98 pediatric patients were included, GD1: 80, GD3: 18; mean age: 7.2 (0.17-16.5) years, 58 (59.2%) males and 40 (40.8%) females. Forty-five were diagnosed ≤ 1994 and 53 ≥ 1995. Genotype: N370S/N370S: 2 (2.0%), N370S/L444P: 27 (27.5%), N370S/other: 47 (48%), L444P/L444P: 7 (7.1%), L444P/D409H: 2 (2.0%), L444P/other: 3 (6.2%), other/other: 10 (10.2%). The mean age at diagnosis was earlier in patients diagnosed after 1995 (p < 0.001) and different between the subtypes, GD1: 8.2 (0.2-16.5) years and GD3: 2.8 (0.17-10.2) years (p < 0.001). There were more severe patients in the group diagnosed before 1994 (p = 0.045) carrying L444P (2), D409H (2), G377S (1), G195W (1) or the recombinant mutation. The patients' diagnosed ≤1994 showed worse cytopenias, higher chance of bone vascular complications at diagnosis and previous spleen removal. The patients started ERT at a median time after diagnosis of 5.2 years [cohort A] and 1.6 years [cohort B] (p < 0.001). CONCLUSIONS: The early diagnosis of Gaucher disease in the era of ERT availability has permitted to reduce the incidence of severe and irreversible initial complication in pediatric patients, and this has permitted better development of these patients. This is the largest pediatric cohort from a national registry.

Spontaneous formation of spiral-like patterns with distinct periodic physical properties by confined electrodeposition of Co-In disks.

Spatio-temporal patterns are ubiquitous in different areas of materials science and biological systems. However, typically the motifs in these types of systems present a random distribution with many possible different structures. Herein, we demonstrate that controlled spatio-temporal patterns, with reproducible spiral-like shapes, can be obtained by electrodeposition of Co-In alloys inside a confined circular geometry (i.e., in disks that are commensurate with the typical size of the spatio-temporal features). These patterns are mainly of compositional nature, i.e., with virtually no topographic features. Interestingly, the local changes in composition lead to a periodic modulation of the physical (electric, magnetic and mechanical) properties. Namely, the Co-rich areas show higher saturation magnetization and electrical conductivity and are mechanically harder than the In-rich ones. Thus, this work reveals that confined electrodeposition of this binary system constitutes an effective procedure to attain template-free magnetic, electric and mechanical surface patterning with specific and reproducible shapes.

A new reversal mode in exchange coupled antiferromagnetic/ferromagnetic disks: distorted viscous vortex.

Magnetic vortices have generated intense interest in recent years due to their unique reversal mechanisms, fascinating topological properties, and exciting potential applications. In addition, the exchange coupling of magnetic vortices to antiferromagnets has also been shown to lead to a range of novel phenomena and functionalities. Here we report a new magnetization reversal mode of magnetic vortices in exchange coupled Ir20Mn80/Fe20Ni80 microdots: distorted viscous vortex reversal. In contrast to the previously known or proposed reversal modes, the vortex is distorted close to the interface and viscously dragged due to the uncompensated spins of a thin antiferromagnet, which leads to unexpected asymmetries in the annihilation and nucleation fields. These results provide a deeper understanding of the physics of exchange coupled vortices and may also have important implications for applications involving exchange coupled nanostructures.

[Trend in the susceptibility of the most frequent bacterial pathogens isolated at Hospital General La Mancha Centro over 2010-2012 period]. / Tendencia de sensibilidad de los patógenos bacterianos más frecuentemente aislados en el Hospital General La Mancha Centro durante el periodo 2010-2012.

Introduction. Our objective was to determine the trend of the antimicrobial susceptibility of the most common bacterial pathogens isolated in La Mancha Centro Hospital (MCH) between 2010-2012. Material and methods. Isolates of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa from patients admitted to MCH were studied. These data and their antibiotic susceptibility were obtained from the database OBSERVA (BioMérieux). Results. The percentages of susceptibility for S. aureus were: 50% methicillin-resistant-S. aureus (MRSA) (higher co-resistance to erythromycin and levofloxacin), 46% erythromycin, 73% clindamycin, 45% levofloxacin, 99% rifampin and 100% cotrimoxazole, glycopeptides, linezolid and daptomycin. Increased resistance in ICU was observed (63% MRSA), with 50% of S. aureus (susceptible and methicillin-resistant strains) with vancomycin MIC values ≥ 0.5 mg/L. E. coli susceptibility: 62% amoxicillin-clavulanate, 55% ciprofloxacin, 60% cotrimoxazole, 84% gentamicin and 95% fosfomycin. K. pneumoniae susceptibility: 74% amoxicillin-clavulanate, 71% ciprofloxacin, 78% cotrimoxazole, 94% gentamicin and 87% fosfomycin. The percentage of BLEE strains was 17% and 21% for E. coli and K. pneumoniae, respectively, without detection of resistance to carbapenems. P. aeruginosa susceptibility: 80% ceftazidime and carbapenems, 63% ciprofloxacin and higher than 90% aminoglycosides. A decreasing trend of susceptibility to ceftazidime and carbapenems was observed in ICU and increasing trend to ciprofloxacin. Conclusions. Resistance percentages were higher in ICU than in the rest of the hospital, highlighting 63% of MRSA strains. Our percentage of BLEE and MRSA strains were higher than the Spanish media. Rifampicin and cotrimoxazole maintain good susceptibility to S. aureus, fosfomycin and aminoglycosides to Enterobacteriaceae and carbapenems to P. aeruginosa.

Tendencia de sensibilidad de los patógenos bacterianos más frecuentemente aislados en el Hospital General La Mancha Centro durante el periodo 2010-2012 / Trend in the susceptibility of the most frequent bacterial pathogens isolated at Hospital General La Mancha Centro over 2010-2012 period

Introducción. Nuestro objetivo fue determinar la tendencia de sensibilidad a los antimicrobianos de los patógenos bacterianos más frecuentes en el Hospital La Mancha Centro (HGMC) entre 2010-2012. Material y métodos. Se estudiaron los aislamientos de Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae y Pseudomonas aeruginosa de los pacientes ingresados en el HGMC. Estos datos y su sensibilidad antibiótica se obtuvieron de la base de datos OBSERVA (BioMérieux). Resultados. Los porcentajes de sensibilidad de S. aureus fueron: 50% S. aureus resistentes a meticilina (SARM) (mayor corresistencia con eritromicina y levofloxacino), 46% eritromicina, 73% clindamicina, 45% levofloxacino, 99% rifampicina y 100% cotrimoxazol, glicopéptidos, linezolid y daptomicina. Se observa mayor resistencia en UCI (63% SARM), con un 50% de S. aureus (sensible y resistente a meticilina) con CMI de vancomicina ≥ 0,5 mg/L. Los porcentajes de sensibilidad de E. coli: 62% amoxicilina-clavulánico, 55% ciprofloxacino, 60% cotrimoxazol, 84% gentamicina y 95% fosfomicina. Los porcentajes de sensibilidad de K. pneumoniae: 74% amoxicilina-clavulánico, 71% ciprofloxacino, 78% cotrimoxazol, 94% gentamicina y 88% fosfomicina. El porcentaje de cepas BLEE fue 17% y 21% para E. coli y K. pneumoniae, respectivamente, sin detección de resistencias a carbapenemas. Los porcentajes de sensibilidad de P. aeruginosa: 80% ceftazidima y carbapenemas, 63% ciprofloxacino, y > 90% aminoglucósidos. En UCI la tendencia de sensibilidad fue descendente para ceftazidima y carbapenemas y ascendente para ciprofloxacino. Conclusiones. Las resistencias fueron mayores en UCI, destacando un 63% de cepas SARM. El porcentaje de cepas BLEE y SARM fueron superiores a la media española. Rifampicina y cotrimoxazol mantienen buena sensibilidad para S. aureus, fosfomicina y carbapenemas para enterobacterias y aminoglucósidos para P. aeruginosa (AU)

Introduction. Our objective was to determine the trend of the antimicrobial susceptibility of the most common bacterial pathogens isolated in La Mancha Centro Hospital (MCH) between 2010-2012. Material and methods. Isolates of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa from patients admitted to MCH were studied. These data and their antibiotic susceptibility were obtained from the database OBSERVA (BioMérieux). Results. The percentages of susceptibility for S. aureus were: 50% methicillin-resistant-S. aureus (MRSA) (higher co-resistance to erythromycin and levofloxacin), 46% erythromycin, 73% clindamycin, 45% levofloxacin, 99% rifampin and 100% cotrimoxazole, glycopeptides, linezolid and daptomycin. Increased resistance in ICU was observed (63% MRSA), with 50% of S. aureus (susceptible and methicillin-resistant strains) with vancomycin MIC values ≥ 0.5 mg/L. E. coli susceptibility: 62% amoxicillin-clavulanate, 55% ciprofloxacin, 60% cotrimoxazole, 84% gentamicin and 95% fosfomycin. K. pneumoniae susceptibility: 74% amoxicillin-clavulanate, 71% ciprofloxacin, 78% cotrimoxazole, 94% gentamicin and 87% fosfomycin. The percentage of BLEE strains was 17% and 21% for E. coli and K. pneumoniae, respectively, without detection of resistance to carbapenems. P. aeruginosa susceptibility: 80% ceftazidime and carbapenems, 63% ciprofloxacin and higher than 90% aminoglycosides. A decreasing trend of susceptibility to ceftazidime and carbapenems was observed in ICU and increasing trend to ciprofloxacin. Conclusions. Resistance percentages were higher in ICU than in the rest of the hospital, highlighting 63% of MRSA strains. Our percentage of BLEE and MRSA strains were higher than the Spanish media. Rifampicin and cotrimoxazole maintain good susceptibility to S. aureus, fosfomycin and aminoglycosides to Enterobacteriaceae and carbapenems to P. aeruginosa (AU)

Green electrochemical template synthesis of CoPt nanoparticles with tunable size, composition, and magnetism from microemulsions using an ionic liquid (bmimPF6).

Electrodeposition from microemulsions using ionic liquids is revealed as a green method for synthesizing magnetic alloyed nanoparticles, avoiding the use of aggressive reducing agents. Microemulsions containing droplets of aqueous solution (electrolytic solution containing Pt(IV) and Co(II) ions) in an ionic liquid (bmimPF6) define nanoreactors in which the electrochemical reduction takes place. Highly crystalline hcp alloyed CoPt nanoparticles, in the 10-120 nm range with a rather narrow size distribution, have been deposited on a conductive substrate. The relative amount of aqueous solution to ionic liquid determines the size of the nanoreactors, which serve as nanotemplates for the growth of the nanoparticles and hence determine their size and distribution. Further, the stoichiometry (Pt(x)Co(1-x)) of the particles can be tuned by the composition of the electrolytic solution inside the droplets. The control of the size and composition of the particles allows tailoring the room-temperature magnetic behavior of the nanoparticles from superparaparamagnetic to hard magnetic (with a coercivity of HC = 4100 Oe) in the as-obtained state.

Highly efficient broadband ultrafast plasmonics.

To date, considerable experimental and theoretical focus has been placed on the spatial control of Surface Plasmon Polaritons (SPPs) using nanostructured surfaces; however, research aimed toward accessing the ultrafast dynamics of SPPs remains vastly unexplored. Despite this, SPPs have the potential to exhibit some of the fastest possible optical processes, while maintaining the advantage of nanoscale spatial manipulation. Here, we present an experimental and computational investigation of a system that provides access to the efficient excitation of broadband, propagating SPP modes. To achieve this, a surface array of tailor designed, reduced symmetry nanostructures has been fabricated to enable the required control of the plasmon dispersion map to match sub 20 fs pulses in the near infra-red. Using a combination of optical spectroscopy and frequency resolved optical gating techniques, complimented by finite element computational analysis, the efficient excitation of propagating broadband plasmonic modes is demonstrated.

[Congenital vallecular cyst with weight disorders. Case report]. / Quiste congénito de la valécula con alteraciones del peso. Caso clínico.

Vallecula cysts are a rare condition in children, with stridor being the most common symptom and growth alterations the more uncommon. We present a 2 months-old child referred by low weight gain from birth, with a history of choking when feeding. He had no respiratory distress but struck mouth breathing and neck hyperextension with lateralization to the right. The esophagogram showed a mass displacing hypopharynx and larynx reflux of contrast into the bronchial tree. The cyst was resected by direct laryngoscopy with marsupialization technique. The outcome was favorable, without recurrence until the fourth month of monitoring.

Improving the magnetic properties of Co-CoO systems by designed oxygen implantation profiles.

Oxygen implantation in ferromagnetic Co thin films is shown to be an advantageous route to improving the magnetic properties of Co-CoO systems by forming multiple nanoscaled ferromagnetic/antiferromagnetic interfaces homogeneously distributed throughout the layer. By properly designing the implantation conditions (energy and fluence) and the structure of the films (capping, buffer, and Co layer thickness), relatively uniform O profiles across the Co layer can be achieved using a single-energy ion implantation approach. This optimized configuration results in enhanced exchange bias loop shifts, improved loop homogeneity, increased blocking temperature, reduced relative training effects and increased retained remanence in the trained state with respect to both Co/CoO bilayers and O-implanted Co films with a Gaussian-like O depth profile. This underlines the great potential of ion implantation to tailor the magnetic properties by controllably modifying the local microstructure through tailored implantation profiles.

Quiste congénito de la valécula con alteraciones del peso: Caso clínico / Congenital vallecular cyst with weight disorders: Case report

Los quistes de la valécula son un trastorno raro en los niños; el estridor es el síntoma más frecuente y la alteración del crecimiento, el más infrecuente. Se presenta el caso de un niño de 2 meses referido por la escasa ganancia ponderal desde su nacimiento, con antecedentes de atragantamiento al alimentarse. No presentaba dificultad respiratoria, pero llamaba la atención la respiración bucal y la hiperextensión del cuello con lateralización hacia la derecha. El esofagograma mostró una masa hipofaríngea que desplazaba la laringe y reflujo del medio de contraste hacia el árbol bronquial. Por laringoscopia directa se resecó un quiste con técnica de marsupialización. La evolución fue favorable, sin recidivas, hasta el cuarto mes de seguimiento.

Vallecula cysts are a rare condition in children, with stridor being the most common symptom and growth alterations the more uncommon. We present a 2 months-old child referred by low weight gain from birth, with a history of choking when feeding. He had no respiratory distress but struck mouth breathing and neck hyperextension with lateralization to the right. The esophagogram showed a mass displacing hypopharynx and larynx reflux of contrast into the bronchial tree. The cyst was resected by direct laryngoscopy with marsupialization technique. The outcome was favorable, without recurrence until the fourth month of monitoring.

Quiste congénito de la valécula con alteraciones del peso: Caso clínico / Congenital vallecular cyst with weight disorders: Case report

Los quistes de la valécula son un trastorno raro en los niños; el estridor es el síntoma más frecuente y la alteración del crecimiento, el más infrecuente. Se presenta el caso de un niño de 2 meses referido por la escasa ganancia ponderal desde su nacimiento, con antecedentes de atragantamiento al alimentarse. No presentaba dificultad respiratoria, pero llamaba la atención la respiración bucal y la hiperextensión del cuello con lateralización hacia la derecha. El esofagograma mostró una masa hipofaríngea que desplazaba la laringe y reflujo del medio de contraste hacia el árbol bronquial. Por laringoscopia directa se resecó un quiste con técnica de marsupialización. La evolución fue favorable, sin recidivas, hasta el cuarto mes de seguimiento.(AU)

Vallecula cysts are a rare condition in children, with stridor being the most common symptom and growth alterations the more uncommon. We present a 2 months-old child referred by low weight gain from birth, with a history of choking when feeding. He had no respiratory distress but struck mouth breathing and neck hyperextension with lateralization to the right. The esophagogram showed a mass displacing hypopharynx and larynx reflux of contrast into the bronchial tree. The cyst was resected by direct laryngoscopy with marsupialization technique. The outcome was favorable, without recurrence until the fourth month of monitoring.(AU)

Botulinum toxin type A in chronic plantar fasciitis: clinical effects one year after injection.

OBJECTIVE: To determine whether the efficacy of botulinum toxin type A in chronic plantar fasciitis was maintained for more than six months after treatment. DESIGN: Observational follow-up study. SUBJECTS: Twenty-four patients who received botulinum toxin type A injection in a previous randomized study of chronic plantar fasciitis (active treatment group) and who presented a benefit one month after treatment. METHODS: A visual analogue scale for pain and the Foot Health Status Questionnaire were used to re-evaluate results 12 months after the botulinum toxin injection. No further injections of botulinum toxin had been administered during the follow-up period. Patients were also asked to give a subjective assessment of treatment outcome. RESULTS: At 12 months, compared with the six-month evaluation, there was a further improvement in foot pain measured using the visual analogue scale, though this did not reach significance (1.78 at 6 months versus 1.22 at 12 months; P = 0.142). However, there were significant improvements in two domains of Foot Health Status Questionnaire: foot pain (91.11 at 6 months versus 80.00 at 12 months; P = 0.001) and foot function (96.19 at 6 months versus 89.38 at 12 months; P = 0.047). There was a small, non-significant deterioration in the shoe and foot health domains. Satisfaction with the outcome was good or very good in the large majority of patients. CONCLUSIONS: In patients with chronic plantar fasciitis, the positive effect detected six months after treatment with botulinum toxin type A was maintained at 12 months and there was a further improvement in pain and foot function.