Bacteremia caused by Aeromonas species in patients with cancer: Clinical manifestations and outcomes.

INTRODUCTION: Oncologic patients can have severe infections due to Aeromonas. This study aims to investigate the clinical characteristics and outcomes of cancer patients with bloodstream infections (BSI) caused by Aeromonas. METHODOLOGY: We included patients with bacteremia caused by Aeromonas species from 2011 to 2018. RESULTS: Seventy-five BSI events in the same number of patients were identified. Forty patients were men (53.3%); the mean age was 49 years (IQR 28-61). A. caviae was the most frequent isolate (n = 29, 38.6%), followed by A. hydrophila (n = 23, 30.6%), A. sobria (n = 15, 20%), and A. veronii (n = 8, 10.6%). The most frequent underlying diagnosis was hematologic malignancy (n = 33, 44%), followed by breast cancer (n = 12, 16%) and gastrointestinal tract cancer (n = 8, 10.6%). The most frequent type of bacteremia was CRBSI in 32 cases (42.6%), followed by mucosal barrier injury-laboratory confirmed BSI (n = 20, 26.7%). Sixteen (26.2%) were hospital-acquired BSI. Attributable mortality occurred in 11 patients (14.6%). In univariate analysis A. hydrophila bacteremia, liver failure, skin/soft tissue infection, septic shock, inappropriate antimicrobial treatment, and relapse or cancer progression were associated with 30-day mortality. In multivariate analysis, only septic shock, inappropriate antimicrobial treatment, and relapse or cancer progression were associated with 30-day mortality. CONCLUSIONS: Aeromonas species should be considered one of the causative pathogens of healthcare-associated bacteremia, especially in immunocompromised patients. In addition, it can be associated with high fatality, particularly in patients with severe clinical infections.

Factores asociados a la reacción de estrés agudo en gestantes con hiperémesis gravídica hospitalizadas en el Instituto Nacional Materno Perinatal, Lima, Perú (2021) / Factors associated with the acute stress reaction in pregnant women with hyperemesis gravidarum hospitalized at the National Maternal Perinatal Institute, Lima, Peru (2021)

Objetivo. Determinar los factores que se encuentran asociados a la hiperémesis y reacción de estrés agudo en gestantes hospitalizadas con hiperémesis gravídica en el Instituto Nacional Materno Perinatal, durante el 2021. Materiales y Métodos. Esta investigación corresponde a un estudio analítico, observacional, de tipo casos y controles, donde se recopilaron las historias clínicas de pacientes gestante hospitalizadas por hiperémesis gravídica atendidas por el servicio de psicología las cuales presentaron reacción de estrés agudo cumpliendo los criterios de inclusión y exclusión. Se realizó un análisis de frecuencias y porcentajes de las diferentes variables y un análisis multivariado para encontrar los factores significativos (p<0.05) y el cálculo de los Odds Ratio (OR) con un nivel de confianza del 95%; este modelo fue evaluado mediante una regresión logística múltiple. Resultados. Se encontró relación entre la planificación del embarazo (p<0.044, ß=0.957 y OR=2.6047) y el rechazo a las náuseas (p<0.028, ß=1.774 y OR=5.893) en gestantes con hiperémesis gravídica. Se halló relación directa entre la reacción de estrés agudo en gestantes con hiperémesis gravídica, respecto a la perdida gestacional (p<0.043, ß=0.933 y OR=2.542) y hospitalización en zona COVID-19 (p<0.010, ß=1.467 y OR=4.335); e inversa, respecto a la aceptación del embarazo (p<0.014, ß=-1.515 y OR=0.220). Conclusión. Se encontraron dos variables asociadas a la presencia de hiperémesis gravídica (planificación del embarazo y el rechazo a las náuseas). La reacción de estrés agudo se ha relacionado con dos factores asociados a las pacientes (perdida gestacional y aceptación del embarazo) y una asociada a la pandemia (hospitalización en zona COVID-19) las cuales explican el 32% de la varianza.

Adherence to treatment in Parkinson's disease: A multicenter exploratory study with patients from six Latin American countries.

BACKGROUND: Adherence to treatment in Parkinson's disease (PD) is compromised due to the need for multiple therapies, comorbidities related to aging, and the complexity of therapeutic schemes. In the present study, we aimed to explore adherence to treatment in groups of PD patients from six Latin-American (LA) countries and identify its associated demographic and clinical parameters. METHODS: A multicenter, cross-sectional, exploratory study was conducted from September 2016 to March 2017. Treatment adherence was assessed using the simplified medication adherence questionnaire (SMAQ), applied to patients and caregivers. Sociodemographic and clinical variables (MDS-UPDRS Part III-IV, MMSE, Beck Depression Inventory-II (BDI-II)) were recorded. RESULTS: Eight hundred patients from six LA countries were evaluated. Nonadherence was reported in 58.25% of the population, according to patients. The most frequent issues were forgetfulness and correct timing of doses. A high level of agreement in adherence prevalence and most SMAQ items were observed between patients and their caregivers. The nonadherent population had a significantly higher proportion of unemployment, free access to medication, troublesome dyskinesias and off-periods, lesser years of education, and worse motor, cognitive, and mood scores. In multiple logistic and linear regression analyses, MDS-UPDRS Part III, BDI-II, gender, free access to medication, treatment with dopamine agonists alone, years of education, excessive concerns about adverse effects, and beliefs about being well-treated remained significant contributors to adherence measures. CONCLUSION: Educational strategies, greater involvement of PD patients in decision-making, and consideration of their beliefs and values might be of great need to improve medication adherence in this PD population.

Effect of porosity and active area on the assessment of catalytic activity of non-precious metal electrocatalyst for oxygen reduction.

We describe a method to study porous thin-films deposited onto rotating disc electrodes (RDE) applied to non-platinum group electrocatalyst obtained by pyrolysis of iron phthalocyanine and carbon, FePc/C. The electroactive area and porous properties of the thin film electrodes were obtained using electrochemical impedance spectroscopy under the framework of de Levie impedance model. The electrocatalytic activity of different electrodes was correlated to the total electroactive area (Ap) and the penetration ratio parameter through the film under ac current. The cylindrical pore model was extended to the RDE boundary conditions and derived in a Koutecky-Levich type expression that allowed to separate the effect of the electroactive area and structural properties. The resulting specific electrocatalytic activity of FePc/C heat treated at different temperatures was correlated to FePc surface concentration.

Demetalation of Surface Porphyrins at the Solid-Liquid Interface.

Understanding the factors that control the demetalation of surface porphyrins at the solid-liquid interface is important as the molecular properties of porphyrins are largely determined by their metal centers. In this work, we used X-ray photoelectron spectroscopy (XPS) to follow the demetalation of Zn and Cd tetraphenylporphyrin molecules (ZnTPP and CdTPP) adsorbed as three-monolayer-thin multilayer films on Au(111), by exposing the molecular layers to acidic aqueous solutions. We found that porphyrin molecules at the solid-liquid interface are less prone to lose their metal center than molecules in solution. We propose that this behavior is due to either the incoming protons provided by the solution or the outgoing metal ion having to pass through the hydrophobic porphyrin multilayers where they cannot be solvated. Our results are relevant for the design of molecular devices based on porphyrin molecules adsorbed on solid surfaces.

Electronic Structure of a Self-Assembled Monolayer with Two Surface Anchors: 6-Mercaptopurine on Au(111).

The electronic structure of aromatic and aliphatic thiols on Au(111) has been extensively studied in relation to possible applications in molecular electronics. In this work, the effect on the electronic structure of an additional anchor to the S-Au bond using 6-mercaptopurine as a model system has been investigated. Results from X-ray photoelectron spectroscopy, near-edge X-ray absorption fine structure spectroscopy, and density functional theory (DFT) confirm that this molecule adsorbs on Au(111) with S-Au and iminic N-Au bonds. Combined ultraviolet photoelectron spectroscopy and DFT data reveal that formation of the 6MP self-assembled monolayer generates a molecular dipole perpendicular to the surface, with negative charges residing at the metal/monolayer interface and positive charges at the monolayer/vacuum interface, which lowers the substrate work function. Scanning tunneling microscopy shows two surface molecular domains: a well-ordered rectangular lattice where molecules are tilted on average 30° with respect to the substrate and aligned 6MP islands where molecules are standing upright. Finally, we found a new electronic state located at -1.7 eV with respect to the Fermi level that corresponds to a localized π molecular state, while the state corresponding to the N-Au bond is hybridized with Au d electrons and stabilized at much lower energies (-3 eV).

[Arachnoiditis and tuberculuos cortical encephalitis in an HIV+ patient]. / Aracnoiditis y encefalitis cortical tuberculosa en un paciente con VIH.

HIV infection is a major risk factor for tuberculosis. We describe the case of a 30-year-old male presenting with headache, compromised mental status, seizures, neck stiffness and fever that was subsequently diagnosed with HlV and neuroinfection. Clinical data, cerebrospinal fluid and brain imaging supported a diagnosis of neurotuberculosis. Cranial magnetic resonance imaging showed diffuse arachnoidal enhancement, mainly at the basal cisterns and cortical encephalitis. Such imaging findings play a key role in the diagnosis of central nervous system tuberculosis.

Aracnoiditis y encefalitis cortical tuberculosa en un paciente con VIH / Arachnoiditis and tuberculuos cortical encephalitis in an HIV+ patient

La infección por VIH es uno de los mayores factores de riesgo para tuberculosis. Presentamos el caso de un paciente de 30 años que ingresó al hospital con datos neurológicos caracterizados por cefalea, alteración del alerta, crisis convulsivas, signos meníngeos y fiebre, a quien subsecuentemente se le diagnosticó VIH y neuroinfección. Los datos clínicos, el examen del líquido cefalorraquídeo y la neuroimagen sustentaron el diagnóstico de neurotuberculosis. La resonancia magnética de cráneo reveló aracnoiditis generalizada de predominio basal, así como encefalitis cortical. Los hallazgos de imagen desempeñan un papel fundamental en el diagnóstico integral de la tuberculosis del sistema nervioso central.

HIV infection is a major risk factor for tuberculosis. We describe the case of a 30-year-old male presenting with headache, compromised mental status, seizures, neck stiffness and fever that was subsequently diagnosed with HlV and neuroinfection. Clinical data, cerebrospinal fluid and brain imaging supported a diagnosis of neurotuberculosis. Cranial magnetic resonance imaging showed diffuse arachnoidal enhancement, mainly at the basal cisterns and cortical encephalitis. Such imaging findings play a key role in the diagnosis of central nervous system tuberculosis.