Applications of MALDI-TOF Mass Spectrometry to the Identification of Parasites and Arthropod Vectors of Human Diseases.

Arthropod vectors and parasites are identified morphologically or, more recently, by molecular methods. Both methods are time consuming and require expertise and, in the case of molecular methods, specific devices. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) identification of bacteria has meant a major change in clinical microbiology laboratories because of its simplicity, speed and specificity, and its capacity to identify microorganisms, in some cases, directly from the sample (urine cultures, blood cultures). Recently, MALDI-TOF MS has been shown as useful for the identification of some parasites. On the other hand, the identification of vector arthropods and the control of their populations is essential for the control of diseases transmitted by arthropods, and in this aspect, it is crucial to have fast, simple and reliable methods for their identification. Ticks are blood-sucking arthropods with a worldwide distribution, that behave as efficient vectors of a wide group of human and animal pathogens, including bacteria, protozoa, viruses, and even helminths. They are capable of parasitizing numerous species of mammals, birds and reptiles. They constitute the second group of vectors of human diseases, after mosquitoes. MALDI-TOF MS has been shown as useful for the identification of different tick species, such as Ixodes, Rhipicephalus and Amblyomma. Some studies even suggest the possibility of being able to determine, through MALDI-TOF MS, if the arthropod is a carrier of certain microorganisms. Regarding mosquitoes, the main group of vector arthropods, the possibility of using MALDI-TOF MS for the identification of different species of Aedes and Anopheles has also been demonstrated. In this review, we address the possibilities of this technology for the identification of parasites and arthropod vectors, its characteristics, advantages and possible limitations.

Influencia de la localización del tumor en la sobrecarga del cuidador principal en pacientes hospitalizados con cáncer avanzado / Influence of tumor location on primary caregiver burden in hospitalized patients with advanced cancer

Introducción: La sobrecarga del cuidador/a aumenta el sufrimiento de pacientes y familiares. Se han realizado pocos trabajos sobre los factores relacionados con ello, incluidos los clínicos o biográficos. Objetivo: Analizar el impacto de la localización de la neoplasia y otros factores sobre la sobrecarga del cuidador/a. Métodos: Estudio descriptivo analítico transversal en una unidad de cuidados paliativos para pacientes con cáncer avanzado. Criterios de inclusión: mayores de 18 años con diagnóstico de cáncer avanzado, con un cuidador/a identificable. Se recogieron variables tanto del paciente como del cuidador/a, incluidos elementos biográficos y clínicos. La sobrecarga se midió mediante la escala de Zarit (EZ) de 22 y 7 ítems, así como una escala 0-10 para sobrecarga autopercibida y la Hospital Anxiety and Depression Scale (HADS) del cuidador/a. Resultados: Se incluyeron 38/65 casos (58 %). La edad media fue de 75 y 58 años para pacientes y cuidadores (50 % hijas), con la localización digestiva del tumor como la más frecuente. La mayoría de los cuidadores trabajaban también fuera de casa, con un 58 % cuidando más de 6 meses. Medias: EZ22 = 46 (DE = 15); EZ7 = 16 (DE = 6). La ubicación digestiva mostró menos carga en las escalas EZ22, EZ7 y 0-10 (p = 0,048), y la ubicación pulmonar se asoció con puntuaciones más altas en la HADS-Ansiedad. Los pacientes con delirium, antecedentes de salud mental o inestabilidad clínica se asociaron con puntuaciones EZ22 más altas (p < 0,05). En aquellos con EZ22 > 46, la HADS-Ansiedad y la HADS global fueron más altas (p = 0,006 y p = 0,014). (AU)

Background: Caregiver burden increases the suffering of patients and their relatives. Few studies have focused on burden-associated factors, including clinical or biographical characteristics. Aim: To analyze the impact of tumor location and other factors on caregiver burden. Methods: An analytic, descriptive, cross-sectional study was conducted in a palliative care unit for advanced cancer patients. Inclusion criteria included: patients older than 18 years with advanced cancer diagnosis, with a recognizable caregiver, who signed an informed consent. Variables of both patients and caregivers were collected, including biographical items and clinical characteristics. Burden was defined by more than 46 or 15 points in Zarit’s Scale (ZS) of 22 items (ZS22) or 7 (ZS7) items, respectively. We also used a 0-10 scale for self-perceived burden. Caregivers’ HADS scores were also recorded, with more than 10 points in subscales and 16 points in overall score as breakpoints for anxiety or depression. Results: A total of 38/65 cases were included (58 %). Mean age was 75 and 58 years for patients and caregivers (50 % offspring), respectively, with tumor location in the digestive system being most common. Most caregivers also worked out of home, and 58 % had been caring for more than 6 months. Means: ZS22 = 46 (DS = 15); ZS7 = 16 (DS = 6). A digestive location obtained a lower burden score in the ZS22, ZS7, and 0-10 scales (p = 0.048), and a lung location was associated with higher HADS-A scores. Patients with delirium, mental disorders, or clinical instability were associated with higher ZS22 scores (p < 0.05). In those with ZS22 > 46, HADS-A scores and overall scores were higher (p = 0.006 and p = 0.014). (AU)

Unusual clinical presentations of Actinotignum (Actinobaculum) schaalii infection / Presentaciones clínicas inusuales de la infección por Actinotignum (Actinobaculum) schaalii

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Ética y acción humanitaria / No disponible

Los principios de la ética; autoridad, neutralidad, independencia e imparcialidad son básicos en la ayuda humanitaria para ayudar a personas que tienen la condición de victimas(AU)

The principles of éthics; authority, neutrality, Independence and imparciality are basics in humanitarian aid to help people who have the victim's condition(AU)