Treatment patterns, healthcare resource utilization and costs of HER2-negative gastric/gastroesophageal junction cancer.

Aim: To describe treatment patterns, healthcare resource utilization and costs in HER2-negative gastric/gastroesophageal (G/GEJ) cancer in the USA. Methods: Retrospective IQVIA Adjudicated Closed Claims database analysis; patients with HER2-negative G/GEJ cancer initiating systemic therapy between October 2016 and December 2019 were identified. Results: Among 1317 patients, platinum plus taxane regimens (54%) were common in neoadjuvant/adjuvant settings. Platinum-taxane (41%) and platinum-fluoropyrimidine (36%) regimens were common first-line therapies in the metastatic setting. Treatment regimens were heterogeneous in later lines. Hospitalization rates ranged from 39% (first-, second-line metastatic settings) to 61% (neoadjuvant/adjuvant setting). High healthcare resource utilization was driven by high outpatient costs. Mean per-patient per-month outpatient costs combining physician office and hospital visits ranged from US$10,944 to $12,582 (representing 52-70% of total costs). Conclusion: For G/GEJ cancer, systemic regimens varied across lines of therapy with variation increasing with subsequent therapy lines; high healthcare costs persist for systemic treatment, particularly outpatient services.

Temperature increase and frost decrease driving upslope elevational range shifts in Alpine grouse and hares.

Global climate change has led to range shifts in plants and animals, thus threatening biodiversity. Latitudinal shifts have been shown to be more pronounced than elevational shifts, implying that northern range edge margins may be more capable to keeping pace with warming than upper elevational limits. Additionally, global climate change is expected to disadvantage habitat specialists. In the Alps, climatic variation along the elevation gradient allows the coexistence of habitat specialists and generalists. Alpine species are anticipated to adapt their elevational ranges to the change of various climate variables caused by global climate change. Regional differences might buffer elevational shifts. Furthermore, distinct climate variables might differently affect the shifts of habitat specialists and generalists. To study the effect of climate change on Alpine species, we analysed hunting bag, climate and biogeographical data of two grouse species (Tetrao tetrix and Lagopus muta) and two hare species (Lepus timidus varronis and L. europaeus) in Grisons, Switzerland, over a period of 30 years. Our results based on 84,630 harvested specimens were as follows: (1) only three out of seven climate variables changed significantly within the study period. (2) The grouse species significantly shifted towards higher elevations, whereas the hare species only shifted in their minimum/maximum elevations. (3) Hunting elevation of habitat generalists increased more than in habitat specialists. (4) The elevational shifts were mostly related to the number of frost days. (5) Hunting elevation increased especially in the southern biogeographical region. To conclude, all four taxa respond to climate change but habitat generalists more rapidly than habitat specialists. The range shift to higher elevations due to global climate change will lead to a reduction in habitat availability for snow-adapted species. Climate change is thus a serious threat to alpine biodiversity. Regions rich in alpine habitats will have an increased responsibility to conserve these species.

Rural landscape dynamics over time and its consequences for habitat preference patterns of the grey partridge Perdix perdix.

Intensification of agricultural practices has drastically shaped farmland landscapes and generally caused a decline in spatial and temporal heterogeneity, thus leading to changes in habitat quality and food resources and a decline for most farmland birds Europe-wide. The relationship between complex landscape changes and habitat preferences of animals still remains poorly understood. Particularly, temporal and spatial changes in diversity may affect not only habitat choice but also population sizes. To answer that question, we have looked into a severely declining typical farmland bird species, the grey partridge Perdix perdix in a diverse farmland landscape near Vienna to investigate the specific habitat preferences in respect to the change of agricultural landscape over two decades and geographic scales. Using a dataset collected over 7.64 km² and between 2001 and 2017 around Vienna, we calculated Chesson's electivity index to study the partridge's change of habitat selection over time on two scales and between winter and spring in 2017. Although the farmland landscape underwent an ongoing diversification over the two decades, the grey partridges declined in numbers and shifted habitat use to less diverse habitats. During covey period in winter, partridges preferred also human infrastructure reservoirs such as roads and used more diverse areas with smaller fields than during breeding where they selected harvested fields but surprisingly, avoided hedges, fallow land and greening. Known as best partridge habitats, those structures when inappropriately managed might rather function as predator reservoirs. The avoidance behaviour may further be a consequence of increasing landscape structuring and edge effects by civilisation constructions. Besides, the loss in size and quality of partridge farmland is altered by crop choice and pesticides reducing plant and insect food. With declining breeding pairs, the grey partridge does not seem to adjust to these unsustainable landscape changes and farmland practices.

Maternal effects on reproduction in the precocial European hare (Lepus europaeus).

In female mammals, reproduction, and in particular lactation, is the energetically most exigent life-history phase. Reproduction is strongly controlled by body reserves and food availability, so females with better body condition or food supply are believed to have higher reproductive output. Additionally, the growth and mortality of young mammals depends on their postnatal development. Therefore, the degree of precociality affects energetic demands for both mothers and young. To study the reproductive performance of the precocial European hare (Lepus europaeus), we analysed relationships between six predictor variables describing maternal and environmental effects and nine response variables relating to reproduction from 217 captive females. We compared the data with those of precocial and altricial mammal species from an extensive literature search. For hares, we found: (1) Heavier females had heavier litters at birth. (2) In summer and spring, total litter mass was larger than in winter. (3) At the end of lactation, the litters of multiparous females were heavier than those of primiparous females. (4) Both older females and females giving birth for the first time had relatively high leveret mortality during lactation. Comparing our results with the literature for other mammals revealed that the body condition (i.e., body mass) of females before birth is predictive of reproductive parameters in both precocial and altricial species. In the precocial hare, female body condition is no longer predictive of reproductive parameters at the end of lactation, whereas in altricial species, female body condition remains predictive of reproduction (litter mass at the end of lactation, offspring mortality) until the end of lactation. We conclude that these effects are caused by precocial offspring feeding on solid food soon after birth and, thus, being less dependent on the mother's body condition during lactation than altricial offspring. In line with this, precociality might have evolved as a way of buffering offspring against maternal effects.

[Chilean strains of clinical origin of non-O1, non-O139 Vibrio cholerae carry the genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF from secretion system T3SS2 present in an island of pathogenicity]. / Cepas chilenas de origen clínico de Vibrio cholerae no-O1, no-O139 portan los genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF del sistema de secreción T3SS2 presentes en una isla de patogenicidad.

Backgound: The virulence factors of the Vibrio cholerae non-O1, non-O139 strains are not clearly known. The strain of septicemic origin NN1 Vibrio cholerae non-O1, non-O139 was sequenced previously by the Illumina platform. A fragment of the pathogenicity island VPaI-7 of V. parahaemolyticus was detected in its genome. AIM: To detect the virulence genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF in Chilean strains of V. cholerae non-O1, non-O139. METHODS: A total of 9 Chilean strains of clinical origin of Vibrio cholerae non-O1, non-O139 isolated between 2006-2012 were analyzed by conventional PCR assays for type III secretion genes encoded on that island: vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF. Additionally, the presence of the virulence genes hylA and rtxA was determined. In addition, REP-PCR and ERIC-PCR assays were performed. RESULTS: most (6/9) Chilean V. cholerae non-O1, non-O139 strains contain the type III secretion genes vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF, encoded in an island of pathogenicity. In addition, all (9/9) the strains contain the virulence genes hylA and rtxA. CONCLUSION: These results strongly suggest the possibility that those strains possess an important virulence potential in humans.

A Multicenter Study To Evaluate Ceftaroline Breakpoints: Performance in an Area with High Prevalence of Methicillin-Resistant Staphylococcus aureus Sequence Type 5 Lineage.

Ceftaroline (CPT) is a broad-spectrum agent with potent activity against methicillin-resistant Staphylococcus aureus (MRSA). The sequence type 5 (ST5) Chilean-Cordobés clone, associated with CPT nonsusceptibility, is dominant in Chile, a region with high rates of MRSA infections. Here, we assessed the in vitro activity of CPT against a collection of MRSA isolates collected between 1999 and 2018 from nine hospitals (n = 320) and community settings (n = 41) in Santiago, Chile, and evaluated performance across testing methodologies. We found that our hospital-associated isolates exhibited higher CPT MIC distributions (MIC50 and MIC90 of 2 mg/liter) than the community isolates (MIC50 and MIC90 of 0.5 mg/liter), a finding that was consistent across time and independent of the culture source. High proportions (64%) of isolates were CPT nonsusceptible despite the absence of CPT use in Chile. Across methodologies, the Etest underestimated the MIC relative to the gold standard broth microdilution (BMD) test (MIC50 and MIC90 of 1 and 1.5 mg/liter, respectively). There was low (∼51%) categorical agreement (CA) between Etest and BMD results across CLSI and EUCAST breakpoints. The recent revision of CLSI guidelines abolished "very major error" (VME) from the previous guidelines (81%), which perform similarly to the EUCAST guidelines. The level of concordance between CLSI and EUCAST for BMD testing and Etest was >95%. Disk diffusion performed poorly relative to BMD under CLSI (CA, 55%) and EUCAST (CA, 36%) guidelines. Comparison of EUCAST to CLSI for disk diffusion (with EUCAST used as the reference) showed low agreement (CA, 25%; VME, 70%). In summary, CPT-nonsusceptible MRSA are dominant in clinical settings in Chile. Our results provide data to support the reevaluation of CPT breakpoints and to improve agreement across methodologies and agencies.

Gastrointestinal parasite infestation in the alpine mountain hare (Lepus timidus varronis): Are abiotic environmental factors such as elevation, temperature and precipitation affecting prevalence of parasite species?

Information concerning factors regulating Alpine mountain hare (Lepus timidus varronis) populations such as host-parasite interactions is missing as only a few parasitological surveys exist of this subspecies. Parasites are not only dependent on their host but also on suitable environmental conditions for infestation. Abiotic environmental factors have an important regulating role on parasites in mammals. It is estimated that the elevation range of parasites is likely to shift in response to alternate host movement and changes in climate. Here we assess the parasitic infestation in the Alpine mountain hare by analysing the parasites in faeces and comparing the parasite infestation at different elevation ranges and at varied weather conditions for two years in the Austrian Alps. Almost half of the faecal samples were free of parasites (46.2%, n = 52). Most frequent was the infection by Coccidia (46.2%), whereas stomach intestine strongylids, Trichuris spp, and Cestoda were only found in 9.6% of all faeces. Hence, only Coccidia may be prevalent enough to regulate Alpine mountain hare populations in the Austrian Alps. Elevation had a significant positive effect on the infection of animals by Trichuris spp, whereas temperature had a significant negative effect on the infection by any parasite traceable in faeces and, when looking at the parasite groups individually, on Coccidia.

Cepas chilenas de origen clínico de Vibrio cholerae no-O1, no-O139 portan los genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF del sistema de secreción T3SS2 presentes en una isla de patogenicidad / Chilean strains of clinical origin of non-O1, non-O139 Vibrio cholerae carry the genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF from secretion system T3SS2 present in an island of pathogenicity

Resumen Introducción. Los factores de virulencia de las cepas de Vibrio cholerae no-O1, no-O139 no son claramente conocidos. La cepa de origen septicémico NN1 Vibrio cholerae no-O1, no-O139 fue secuenciada previamente mediante la plataforma Illumina, detectándose en su genoma un fragmento de la isla de patogenicidad VPaI-7 de V. parahaemolyticus. Objetivo: detectar los genes de virulencia vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF en cepas chilenas clínicas de V. cholerae no-O1, no-O139. Material y Métodos: Un total de 9 cepas chilenas de origen clínico de Vibrio cholerae no-O1, no-O139 aisladas entre 2006-2012 fueron analizadas mediante ensayos de reacción de polimerasa en cadena (RPC, en inglés PCR) convencional para los genes de secreción tipo III codificados en dicha isla: vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF. Adicionalmente se determinó la presencia de los genes de virulencia hylA y rtxA. Además, se realizaron ensayos de repetitive element palindromic PCR (REP-PCR) y Enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Resultados: la mayoría (6/9) de las cepas chilenas de V. cholerae no-O1, no-O139 contiene todos los genes de secreción tipo III vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF, codificados en una isla de patogenicidad. Además, el total de las cepas (9/9) contiene los genes de virulencia hylA y rtxA. Conclusión: Estos resultados sugieren fuertemente la posibilidad que dichas cepas posean un potencial de virulencia importante en seres humanos.

Backgound: The virulence factors of the Vibrio cholerae non-O1, non-O139 strains are not clearly known. The strain of septicemic origin NN1 Vibrio cholerae non-O1, non-O139 was sequenced previously by the Illumina platform. A fragment of the pathogenicity island VPaI-7 of V. parahaemolyticus was detected in its genome. Aim: To detect the virulence genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF in Chilean strains of V. cholerae non-O1, non-O139. Methods: A total of 9 Chilean strains of clinical origin of Vibrio cholerae non-O1, non-O139 isolated between 2006-2012 were analyzed by conventional PCR assays for type III secretion genes encoded on that island: vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF. Additionally, the presence of the virulence genes hylA and rtxA was determined. In addition, REP-PCR and ERIC-PCR assays were performed. Results: most (6/9) Chilean V. cholerae non-O1, non-O139 strains contain the type III secretion genes vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF, encoded in an island of pathogenicity. In addition, all (9/9) the strains contain the virulence genes hylA and rtxA. Conclusion: These results strongly suggest the possibility that those strains possess an important virulence potential in humans.

Infant perception of von Szily contours.

This habituation-dishabituation study examined infants' perception of subjective von Szily contours, the illusory effect of which is generated by horizontal disparity and half-occlusions. In these contours, a foreground surface appears to partially occlude a background surface. In Experiment 1, participants aged 4 and 5 months were habituated to a von Szily figure and were then tested for their ability to perceive the difference between the habituation figure and the same figure with reversed depth relations. The infants displayed significant novelty preferences during the posthabituation period. This observation indicates that 4- and 5-month-olds respond to the stereoscopically specified depth difference between the two surfaces of von Szily figures. In Experiment 2, participants aged 4 and 5 months were tested for the ability to conduct modal completion, that is, to perceive the surface that is stereoscopically shifted into the foreground as a whole. The infants were habituated to a von Szily figure and then examined for their ability to distinguish between complete and incomplete versions of the foreground surface. Longer looking at the incomplete posthabituation pattern indicates modal completion; the infants recognize the complete pattern as familiar and regard the incomplete pattern as novel. Similarly, Experiment 3 investigated whether infants aged 5 and 7 months amodally complete the background surface, that is, the surface that is partially covered by the foreground surface. Experiment 2 found modal completion in 5-month-olds. Experiment 3 established that 5- and 7-month-olds have developed some ability to conduct amodal completion. In sum, infants perceive the depth information in von Szily contours and conduct modal and amodal completion.

Infants Perceive Three-Dimensional Subjective Contours.

The addition of crossed horizontal disparity enhances the clarity of illusory contours compared to pictorial illusory contours and illusory contours with uncrossed horizontal disparity. Two infant-controlled habituation-dishabituation experiments explored the presence of this effect in infants 5 months of age. Experiment 1 examined whether infants are able to distinguish between a Kanizsa figure with crossed horizontal disparity and a Kanizsa figure with uncrossed horizontal disparity. Experiment 2 tested infants for their ability to differentiate between a Kanizsa figure with crossed horizontal disparity and a two-dimensional Kanizsa figure. The results provided evidence that the participants perceived the two- and the three-dimensional illusory Kanizsa contour, the illusory effect in which was strengthened by the addition of crossed horizontal disparity.

Infants perceive two-dimensional shape from horizontal disparity.

Previous studies observed that responsiveness to horizontal disparity as such emerges at approximately 2 months of age. Moreover, 3- to 4-month-old infants utilize stereoscopic information to perceive object variations in depth. The present study investigated infants' ability to respond to crossed horizontal disparity information that defines two-dimensional shape. Infants 4 and 5 months of age were habituated to either a cross or the outline of a square. During the posthabituation period, they were presented with both shapes. The stimuli were dynamic random dot stereograms shown on an autostereoscopic monitor. The participants 5 but not 4 months of age displayed significant novelty preferences for the unfamiliar shape during the posthabituation period. Five-month-old infants are hence sensitive to horizontal disparity information that specifies shape.

Network analysis of empathy items from the interpersonal reactivity index in 1973 young adults.

The aim of this work is to perform a network analysis on the French adaptation of the interpersonal reactivity index (IRI) scale from a large Belgian database and provide additional information for the construct of empathy. We analyze a database of 1973 healthy young adults who were queried on the IRI scale. A regularized partial correlation network is estimated. In the visualization of the model, items are displayed as nodes, edges represent regularized partial correlations between the nodes. Centrality denotes a node's connectedness with other nodes in the network. The spinglass algorithm and the walktrap algorithm are used to identify communities of items, and state-of-the-art stability analyses are carried out. The spinglass algorithm identifies four communities, the walktrap algorithm five communities. Positive edges are found among nodes belonging to the same community as well as among nodes belonging to different communities. Item 14 ("Other people's misfortunes do not usually disturb me a great deal") shows the highest strength centrality score. The network edges and node centrality order are accurately estimated. Network analysis highlights interesting connections between indicators of empathy; how these results impact empathy models must be assessed in further studies.

Head-to-head comparison of Microflex LT and Vitek MS systems for routine identification of microorganisms by MALDI-TOF mass spectrometry in Chile.

BACKGROUND: Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is a new and revolutionary identification method for microorganisms and has recently been introduced into clinical microbiology in many industrialized countries in Europe and North America. OBJECTIVES: Our study aimed to compare the performance and practicality of two commercial MALDI-TOF MS platforms in a head-to head manner at a routine laboratory in Chile. METHODS: During a five-month period in 2012-13, the diagnostic efficiency (correct identification rate) and agreement between Microflex LT (Bruker Daltonics) and Vitek MS (bioMérieux) was compared in a parallel manner to conventional identification including genotypic analysis for difficult-to-identify strains. The study included 804 microbial isolates: 252 Enterobacteriaceae, 126 non-fermenters, 36 other gram-negative rods, 279 gram-positive cocci, 32 gram-positive rods, 32 anaerobes, and 47 yeasts. Other relevant factors of the two devices such as user friendliness and connectivity were also evaluated and compared. RESULTS: Both systems correctly identified the vast majority (98%) of the isolates to the genus level. Vitek MS reached higher rates of identification to species and species complex level than Microflex LT (81% vs. 85% and 87% vs. 93%, respectively), which was mainly based on the higher performance among coagulase negative staphylococci and Candida isolates. The evaluation of user friendliness and other technical aspects showed only marginal differences, which slightly favored Vitek MS, mainly due to its ready-to-use supplies, easier connectivity and workflow integration, and availability of local technical support. CONCLUSIONS: Both MALDI-TOF MS systems permitted fast and accurate identification of most microbial strains and showed a high level of user-friendliness. The observed differences were marginal and slightly favored Vitek MS, mainly due to practicality and connectivity issues within our setting.

The measurement of alexithymia in children and adolescents: Psychometric properties of the Alexithymia Questionnaire for Children and the twenty-item Toronto Alexithymia Scale in different non-clinical and clinical samples of children and adolescents.

This study had two aims. Firstly, the psychometric properties of the 20-item Toronto Alexithymia Scale (TAS-20) and the Alexithymia Questionnaire for Children (AQC) that measure the three dimensions of alexithymia (DIF, difficulty identifying feelings; DDF, difficulty describing feelings; EOT, externally-oriented thinking) were explored in various samples of children, adolescents or young adults to detect the best factor-structure and to examine if the Externally-Oriented Thinking (EOT) factor must be deleted or not. Secondly, the capacity for adolescents to distinguish between alexithymia and depression was studied using factorial analyses of items of self-report of alexithymia and depression scales. Four groups were examined (80 healthy children, 105 adolescents with various psychiatric disorders, 333 healthy older adolescents and 505 young adults recruited from universities). The first two groups filled out the AQC and the latter two the TAS-20. Confirmatory factorial analyses (CFA) showed that the two-factor model (DIF, DDF) provided acceptable fits and had significant advantages over the three-factor model (DIF, DDF, EOT). Low alpha coefficients for the EOT subscale were reported (range from 0.18-0.61). Except for the children sample, exploratory factorial analyses (EFA) were performed on the items of the TAS-20 or AQC without the EOT items and the Beck depression inventory-II (BDI-II) or the Zung Self-Rating Depression Scale (SDS). The items of the AQC and BDI-II or items of the TAS-20 and SDS loaded on separate factors with only a minor overlap suggesting that adolescents were able to differentiate alexithymia and depression when self-assessments were used. Alexithymia can be reliably assessed in adolescents using the TAS-20 or AQC without the eight items rating the EOT dimension.

Binocular vision in infancy: Responsiveness to uncrossed horizontal disparity.

This research explored the onset of stereopsis, the ability to perceive depth from the different views provided by the two eyes. In a longitudinal study, infants were tested weekly from 6 to 20 weeks of age. The primary goal of the study was to establish the onset and the early development of sensitivity to uncrossed horizontal disparity. The infant participants were shown dynamic random dot stereograms displaying two squares, one with uncrossed horizontal disparity (0.5°) and one with vertical disparity (0.5°). The stimuli were presented on an autostereoscopic monitor. We used two methods, the forced-choice preferential looking (FPL) method and the classical natural preference (CNP) method, to measure whether the infants preferred the uncrossed over the vertical disparity display. According to the FPL data, the mean relative preferences for horizontal over vertical disparity were significantly greater than chance probability (0.50) from 13 weeks of age onward. With the CNP method we found significant preferences for uncrossed horizontal disparity from 15 weeks onward. The FPL method was hence more sensitive than the CNP method as it indicated an earlier onset of responsiveness to stereoscopic information.

French Adaptation of the Narcissistic Personality Inventory in a Belgian French-Speaking Sample.

The Narcissistic Personality Inventory (NPI) is the most widely used self-report scale to assess the construct of narcissism, especially in its grandiosity expression. Over the years, several factor models have been proposed in order to improve the understanding of the multidimensional aspect of this construct. The available data are heterogeneous, suggesting one to at least seven factors. In this study, we propose a French adaptation of the NPI submitted to a sample of Belgian French-speaking students (n = 942). We performed a principal component analysis on a tetrachoric correlation matrix to explore its factor structure. Unlike previous studies, our study shows that a first factor explains the largest part of the variance. Internal consistency is excellent and we reproduced the sex differences reported when using the original scale. Correlations with social desirability are taken into account in the interpretation of our results. Altogether, the results of this study support a unidimensional structure for the NPI using the total score as a self-report measure of the Narcissistic Personality Disorder in its grandiose form. Future studies including confirmatory factor analysis and gender invariance measurement are also discussed.

SELF-REPORT OF EMPATHY: A SHORTENED FRENCH ADAPTATION OF THE INTERPERSONAL REACTIVITY INDEX (IRI) USING TWO LARGE BELGIAN SAMPLES.

For more than 30 years, the Interpersonal Reactivity Index (IRI) has been used to measure the multidimensional aspects of empathy. But the 28-item, 4-factor model of Davis (1980 ) is currently contested because of methodological issues and for theoretical reasons. Confirmatory (CFA) and exploratory factor analyses (EFA) were applied in two French-speaking Belgian student samples (1,244 participants in the first and 729 in the second study) to test this model and to propose a shortened version. A non-optimal fit was found with respect to the CFI value (Study 1). By splitting the student group into two random subsamples, EFA and then CFA were used to propose a 15-item, 4-factor model with good fit indices. A CFA on the second student group (Study 2) replicated this model. Results are discussed considering the influence of social desirability response bias, an absence of strong invariance across sex and the usefulness of self-report scales to measure empathy.

DETERMINATION OF THE CUTOFF THRESHOLD ON THE BERMOND-VORST ALEXITHYMIA QUESTIONNAIRE-20 FORM B: A STUDY OF 560 YOUNG ADULTS.

The aim of the study was to calculate the cutoff scores on the Bermond-Vorst Alexithymia Questionnaire-20 Form B. 560 students completed the Bermond-Vorst Alexithymia Questionnaire-20 Form B and the 20-item Toronto Alexithymia Scale. Using cutoff scores of the French or the original version of the 20-item Toronto Alexithymia Scale as the standard, the participants were divided into alexithymic and non-alexithymic groups. The Bermond-Vorst Alexithymia Questionnaire-20 Form B cutoff scores selection was based on the sensitivity, specificity, receiver operating characteristic curve analysis, and the analyses of the clinical data. The most appropriate cutoff scores for determining the absence and presence of alexithymia ranged from 43 to 45 and from 50 to 53, respectively.

[Streptococcus gallolyticus (ex S. bovis) bacteremia and its relationship with colonic or hepatobiliary disease and endocarditis]. / Bacteriemias por Streptococcus gallolyticus (ex S. bovis) y su relación con patología colónica o hepatobiliar y endocarditis.

BACKGROUND: Bacteremia due to Streptococcus bovis (now S. gallolyticus) has been traditionally associated to colon or hepatobiliar disease and endocarditis but there is no information on this matter in Chile. AIMS: To describe clinical features of adult patients suffering bacteremia by S. bovis/S. gallolyticus, identify the source of the bacteremia and the frequency of endocarditis. METHODS: Retrospective-descriptive study using laboratory records. RESULTS: Between January 2003 and August 2014, 23 S. bovis/S. gallolyticus bacteremic events were identified among 22 patients. Mean age was 72.7 years (range 46-96). Co-morbidities were frequent (9.1 to 47.6%). The primary source of bacteremia was intestinal in 52.2%; hepatobiliar in 17.4% and in 34.8% it was not elucidated. Six patients had infective endocarditis (26.1%) and one patient had espondylodiscitis (4.3%). S. bovis represented 39.1% of isolates (all until 2008), S. gallolyticus subsp pasteurianus 39.1% and, S. gallolyticus subsp infantarius and S. gallolyticus subsp gallolyticus 8.7% each one, respectively. Association studies between the bacteremic source or endocarditis with specific S. gallolyticus subspecies were limited by the small number of isolates. Seven patients (30.4%) underwent surgical interventions. In-hospital mortality reached 21.7% (n=5). CONCLUSIONS: Although infrequent, bacteremic events by S. gallolyticus/S. bovis have increased in-hospital mortality, require surgical intervention and affect older patients with co-morbidities. Near two-thirds suffer from colonic or hepatobiliary disease that act as the primary source of bacteremia. In addition, near one fourth is affected by infective endocarditis. Detection of S. gallolyticus/S. bovis in blood cultures prompts a thorough clinical evaluation in order to clarify the source of the bloodstream infection and the presence of complications.