Physicochemical changes in starch during the conversion of corn to tortilla in the traditional nixtamalization process associated with RS2.

This work aimed to study the changes in starch and isolated starch resulting from the conversion of corn to tortilla, focusing on the orthorhombic crystal structure and its association with resistant starch. Scanning electron microscopy images show whole, partially, and completely damaged starch granules in nixtamalized corn, masa, and tortillas. More importantly, whole isolated starch granules were found in nixtamal, masa, and tortillas. Transmission electron microscopy shows the presence of nanocrystals with orthorhombic structures in isolated starch. Some of them remained almost undamaged during the nixtamalization process. The X-ray patterns showed orthorhombic crystals in nixtamal, masa, and tortilla and their isolated starches. The RS increased from 2.61 to 5.31 % from corn to tortilla and from 2.52 to 5.61 % for isolated starches from corn and tortilla during the traditional nixtamalization process. The results suggest that the nanocrystals in corn to tortilla are part of RS2.

Changes in the physicochemical properties of isolated starch and plantain (Musa AAB Simmonds) flours for early maturity stage.

This work focuses on the study of the physicochemical changes that take place during the first stage of ripening of plantain, with particular attention to the changes in the orthorhombic and hexagonal nanocrystals present in this starch, and its relation shift with resistance starch. Significant changes were observed in the proximal analysis of plantain flour. A gradual increase in moisture content was attributed to the high content of crystalline structures and molecules that can be removed by drying. Water activity increased with ripening, which was attributed to the hygroscopic nature of the flours. The protein content increased, and the carbohydrate content decreased, indicating the progress of biochemical reactions. The changes in the fat content are consistent with the hydrolysis and resynthesis of lipids during the ripening process. The obtained results indicate a significant influence of the ripening stage on the physicochemical properties of flour and starch of plantain, which is associated with the occurrence of a climacteric peak on the 4th day of ripening. The hydration properties of plantain flour decreased significantly during the ripening days, consistent with the occurrence of a climacteric peak. Water holding capacity (WHC) and water binding capacity (WBC) were affected by the degree of digestion of native starch granules and protein denaturation during fruit ripening. Scanning electron microscopes (SEM) showed that during ripening the surface of the isolated starches do not suffer any significative damage. X-ray diffraction patterns were used to identify crystalline structures and to study the changes in the crystalline structures. These results showed that the starch contains orthorhombic and hexagonal nanocrystals, which play and important role and which show small structural damage during ripening reflected in a decrease in their relative crystallinity. This is the first time that these nanocrystals have been studied and considered in the ripening process. Differential scanning calorimetry was used to study the thermal transition in isolated starch. The results indicated that the gelatinization of starch corresponds to the solvation of orthorhombic and hexagonal nanocrystals, and that during ripening there is a decrease in the enthalpy reflecting some crystal structural damage. Pasting properties were studied using a Starch cell for flours and isolated starches, indicating that the pasting profile is governed by intrinsic and extrinsic factors. The resistant starch does not show significant changes at this stage of maturation. This starch is the one with the highest resistant starch content reported in the literature (38%). It was hypothesized that the resistant starch is directly related to the amount of whole starch granules, and more importantly, directly related to the number concentration of orthorhombic and hexagonal nanocrystals. Therefore, knowledge of the physicochemical and nutritional properties of plantain and flour at each stage of ripening allows better selection according to industrial applications.

Microorganismos aislados de hemocultivos en niños con leucemia y linforma: Seis años de seguimiento / Microorganisms isolated from blood cultures in children with leukemia and lymphoma: six years of follow-up

Las Leucemias y linfomas constituyen las enfermedades oncológicas más frecuentes en pediatría y las bacteriemias representan infecciones graves en estos pacientes. Objetivos: describir los microorganismos aislados de sangre en pacientes con leucemia aguda o linfoma pediátrico; comparar la incidencia de aislamientos según enfermedad de base; detallar las variaciones en la incidencia de dichos aislamientos y la evolución de su resistencia antimicrobiana. Estudio retrospectivo, observacional. Se incluyeron 823 episodios de bacteriemia en 467 pacientes pediátricos, entre julio-2016 y junio-2022, dividido en tres períodos (período-1: años 2016- 2018, período-2: años 2018-2020, período-3: años 2020-2022). Se aislaron 880 microorganismos: 55,3% gram negativos (GN), 40% gram positivos (GP) y 4,7% levaduras. En GN predominaron: enterobacterias (72%) y en GP: estreptococos del grupo viridans (SGV) (34,1%). Se encontró asociación entre LLA-enterobacterias (p=0,009) y LMA-SGV (p<0,001). Hubo aumento de GN entre los períodos 1 y 3 (p=0,02) y 2 y 3 (p=0,002) y disminución de GP entre 2 y 3 (p=0,01). Se registraron los siguientes mecanismos de resistencia: BLEE (16,4%), carbapenemasas: KPC (2,5%); MBL (2,7%) y OXA (0,2%); meticilinorresistencia en Staphylococcus aureus (20%) y estafilococos coagulasa negativos (95%), vancomicina resistencia en Enterococcus spp. (39%), SGV no sensibles a penicilina (44%) y a cefotaxima (13%). Hubo aumento de MBL entre los períodos 1 y 2 (p=0,02) y una tendencia en disminución de sensibilidad a penicilina en SGV entre el 1 y 3 (p=0,058). El conocimiento dinámico y análisis de estos datos es esencial para generar estadísticas a nivel local, fundamentales para el diseño de guías de tratamientos empíricos (AU)

Leukemias and lymphomas are the most common cancers in children and bacteremia is a severe infection in these patients. Objectives: to describe the microorganisms isolated from blood in pediatric patients with acute leukemia or lymphoma; to compare the incidence of isolates according to the underlying disease; and to detail the variations in the incidence of these isolates and the evolution of their antimicrobial resistance. Retrospective, observational study. We included 823 episodes of bacteremia in 467 pediatric patients seen between July-2016 and June-2022, divided into three periods (period-1: 2016- 2018, period-2: 2018-2020, period-3: 2020-2022). A total of 880 microorganisms were isolated: 55.3% were gram-negative (GN), 40% gram-positive (GP) and 4.7% yeasts. In GN there was a predominance of: enterobacteria (72%) and in GP viridans group streptococci (VGS) (34.1%). An association was found between ALL-enterobacteria (p=0.009) and AML-VGS (p<0.001). There was an increase in GN between periods 1 and 3 (p=0.02) and 2 and 3 (p=0.002) and a decrease in GP between 2 and 3 (p=0.01). The following resistance mechanisms were recorded: BLEE (16.4%), carbapenemases: KPC (2.5%), MBL (2.7%), and OXA (0.2%); methicillin resistance in Staphylococcus aureus (20%) and coagulase negative staphylococci (95%), vancomycin resistance in Enterococcus spp. (39%), VGS resistant to penicillin (44%) and to cefotaxime (13%). There was an increase in MBL between periods 1 and 2 (p=0.02) and a decreasing trend in penicillin sensitivity in VGS between periods 1 and 3 (p=0.058). Dynamic knowledge and analysis of these data is essential to generate statistics at the local level, which is fundamental for the design of empirical treatment guidelines (AU)

Factores de riesgo de bacteriemia en niños con cáncer y neutropenia febril / Risk factors for bacteremia in children with cancer and febrile neutropenia

La bacteriemia representa una importante causa de morbimortalidad en pacientes oncológicos. Durante el episodio de neutropenia inducida por quimioterapia, un 15%­25% de los pacientes tendrá bacteriemia. Objetivo: identificar factores de riesgo asociados con bacteriemia en pacientes oncológicos pediátricos con neutropenia y fiebre. Material y métodos: estudio de cohorte prospectivo. Se incluyeron pacientes con enfermedades hematooncológicas y neutropenia febril, internados en un hospital pediátrico de alta complejidad entre julio de 2018 y mayo de 2019. Se excluyeron receptores de trasplante de médula ósea. Se compararon las características clínicas según se documentara bacteriemia (B) o no. Resultados: Se incluyeron 160 pacientes (p). Eran varones 93 (58%). La mediana de edad fue 81,5 meses (RIC 36-127,5). La enfermedad de base (EB) más frecuente fue: leucemia linfoblástica aguda (LLA) 88 (55%). Se identificaron 20 (12,5%) pacientes con bacteriemia (B). En el análisis univariado hubo asociación entre B y LMA (p=0,003) y la internación en UCI (p=0,0001). En el modelo multivariado, ajustado por el resto de las variables, se identificaron la LMA (OR 8,24, IC95% 2,5-26,4; p<0,001) y la tiflitis (OR 5,86, IC95% 1,2-27,3; p=0,02) como factores relacionados con bacteriemia. Los principales microorganismos identificados fueron: estreptococos del grupo viridans 6 (30%), Escherichia coli 4 (20%) y estafilococos coagulasa negativos 3 (15%). Quince (75%) fueron bacteriemias secundarias a un foco clínico. El foco más frecuente fue el mucocutáneo (n=7, 35%). En esta cohorte de niños con cáncer y neutropenia febril, los factores asociados con bacteriemia fueron: la LMA, la tiflitis y la internación en UCI (AU)

Bacteremia is an important cause of morbidity and mortality in oncology patients. During an episode of chemotherapy-induced neutropenia, 15%-25% of patients will develop bacteremia. Objective: to identify risk factors associated with bacteremia in pediatric oncology patients with neutropenia and fever. Material and methods: prospective cohort study. Patients with hematology-oncology diseases and febrile neutropenia, admitted to a tertiary-care pediatric hospital between July 2018 and May 2019 were included. Bone marrow transplant recipients were excluded. Clinical characteristics were compared according to whether or not bacteremia was recorded. Results: 160 patients were included of whom 93 (58%) were male. Median age was 81.5 months (IQR 36-127.5). The most common underlying disease was acute lymphoblastic leukemia (ALL) in 88 patients (55%). Twenty (12.5%) patients with bacteremia were identified. In univariate analysis, an association was found between bacteremia and acute myeloid leukemia (AML) (p=0.003) and ICU admission (p=0.0001). In the multivariate model, adjusted for the remaining variables, AML (OR 8.24; 95%CI 2.5-26.4; p<0.001) and typhlitis (OR 5.86; 95%CI 1.2-27.3; p=0.02) were identified as factors related to bacteremia. The main microorganisms identified were viridans group streptococci in 6 (30%), Escherichia coli in 4 (20%), and coagulase negative staphylococci in 3 (15%). In 15 cases (75%), bacteremia was secondary to a clinical focus. The most frequent focus was mucocutaneous (n=7, 35%). In this cohort of children with cancer and febrile neutropenia, the factors associated with bacteremia were AML, typhlitis, and ICU admission (AU)

Heating-cooling extrusion cycles as a method to improve the physicochemical properties of extruded corn starch.

This work proposed a controlled method to modify the physicochemical properties of corn starch through heating and cooling extrusion (HCE) cycles. It was used native corn starch adjusted to 60% moisture. It was then subjected to 5 HCE cycles at 100 and 125 °C, at 10 rpm. Water absorption index (WAI), water solubility index (WSI), resistant starch (RS), thermal properties, viscosity, FTIR, and X-ray were evaluated. For WAI and WSI, a gradual increase was observed on each HCE cycle. Thermal properties shown that enthalpy decrease with each HCE cycles due to more gelatinization. Viscosity properties shown a thermally stable starch conditions being directly proportional to HCE cycles. The RS increased for each 5 HCE. XRD revealed that HCE cycle changed the starch structure from an orthorhombic structure to V-type crystalline structure. Finally, it was concluded that HCE cycles is a method to produce corn starch with controlled physicochemical properties.

Structural changes in popped sorghum starch and their impact on the rheological behavior.

Sorghum has been used to expand snacks such as pop sorghum. However, it is still unknown how the structural changes during the popping affect its rheological and functional properties. This study evaluated the structural changes of popped sorghum starch (PS) and their impact on rheological behavior. Moisture sorghum was adjusted to 11, 15, and 20% before popped. Morphology, X-ray pattern (XRP), infrared spectra (IR), thermal properties, and rheological behavior before and after popping were evaluated. Micrographs showed a honeycomb-like structure in PS. XRP showed partial damage to the orthorhombic crystals of the sorghum starch after PS, while the growth of crystalline lamellae was also generated (13.08 and 20.01°). IR showed structural damage as the signal at 1045 cm-1 disappeared in PS. The IM increased to gelatinization of the starch. The rheological behavior of PS displayed better thermal stability, with the lowest breakdown (25 ± 3.5 cP), setback (253 ± 11.3 cP), and final (1337 ± 5.7 cP) viscosity. The consistency coefficient k and flow behavior index n increase, meaning a loss of the pseudoplastic character. Viscoelastic properties increased in PS, suggesting the formation of cross-links and a stable matrix. Correlation analysis showed a strong relationship between structural changes and the rheological behavior of PS.

Sarcoidosis-like reactions in cancer patients treated with immune checkpoint inhibitors: experience in a Spanish hospital

Background Immune checkpoint inhibitors (ICI) have been associated with several immune-related adverse events, including sarcoidosis-like reactions (SLR). SLR, which has a low prevalence but an increasing incidence, is similar to sarcoidosis in terms of histology, and clinical and radiological manifestations. The most commonly affected organs are hilar and mediastinal lymph nodes and skin. SLR is an exclusion diagnosis, so a lymph node biopsy can be useful to distinguish between tumor progression and SLR, particularly in tumors in which nodal involvement is very common. Patients and methods We performed a retrospective analysis of SLR in all cancer patients receiving ICIs in our institution between January 2016 and June 2020. Results Among the 1063 treated patients, seven experienced SLR, four of whom were symptomatic (cough, skin lesions, arthralgia), with time to onset ranging from 1.5 to 6.7 months after ICI initiation. All seven patients had bilateral hilar lymphadenopathy, and granulomatous reactions in five of the six patients with lymph node biopsies. SLR improved in all patients, including four patients who continued with ICI. Three patients received corticosteroids and/or stopped ICI therapy. Four of these patients had partial responses at the time SLR was identified. Conclusion Management of SLR lacks a consensus recommendation, although corticosteroids and/or stopping the ICI are generally implemented. The potential consequences of stopping anticancer treatment should be taken into consideration, particularly in the absence of clear management recommendations (AU)

Impact of the popping process on the structural and thermal properties of sorghum grains (Sorghum bicolor L. Moench).

The popping process has been widely used as a technique for obtaining snacks. This study evaluated the effect of the popping process on the structural and thermal properties of sorghum. Seven varieties of sorghum were used. Raw sorghum grains were adjusted to 11% moisture and popped at 210 °C for 90 s with hot air. Microstructure, thermal and viscosity properties, and X-Ray and infrared spectrum were measured in raw and popped sorghum. The popping process produced an ordered honeycomb-like structure in the sorghum. The viscosity profile showed an increase in the thermal stability of popped sorghum. DSC measurements showed a starch gelatinization and a second transition about to 145 °C. XRD diffractograms display a reduction in the amplitude of the crystalline orthorhombic structure peaks. Finally, infrared indicated a change in the short-range structure and protein denaturation due to the popping process.

Sarcoidosis-like reactions in cancer patients treated with immune checkpoint inhibitors: experience in a Spanish hospital.

BACKGROUND: Immune checkpoint inhibitors (ICI) have been associated with several immune-related adverse events, including sarcoidosis-like reactions (SLR). SLR, which has a low prevalence but an increasing incidence, is similar to sarcoidosis in terms of histology, and clinical and radiological manifestations. The most commonly affected organs are hilar and mediastinal lymph nodes and skin. SLR is an exclusion diagnosis, so a lymph node biopsy can be useful to distinguish between tumor progression and SLR, particularly in tumors in which nodal involvement is very common. PATIENTS AND METHODS: We performed a retrospective analysis of SLR in all cancer patients receiving ICIs in our institution between January 2016 and June 2020. RESULTS: Among the 1063 treated patients, seven experienced SLR, four of whom were symptomatic (cough, skin lesions, arthralgia), with time to onset ranging from 1.5 to 6.7 months after ICI initiation. All seven patients had bilateral hilar lymphadenopathy, and granulomatous reactions in five of the six patients with lymph node biopsies. SLR improved in all patients, including four patients who continued with ICI. Three patients received corticosteroids and/or stopped ICI therapy. Four of these patients had partial responses at the time SLR was identified. CONCLUSION: Management of SLR lacks a consensus recommendation, although corticosteroids and/or stopping the ICI are generally implemented. The potential consequences of stopping anticancer treatment should be taken into consideration, particularly in the absence of clear management recommendations.

Exploring different profiles of gender (non)conformity in women and their relationship with sexual orientation and mental health.

We examined whether sexual orientation and the Conformity to Feminine Norms (CFN) were predictors of three mental health outcomes: depression, anxiety, and self-esteem. The sample comprised 690 women with different sexual orientations (heterosexual, lesbian and bisexual). Our results suggested that there were five CFN profiles related to sexual orientation, but only the former was a significant predictor of the three mental health outcomes and that women might experience different forms of CFN which in turn can differentially influence women's mental health.

Atomic and Electronic Structure of Solid-Density Liquid Carbon.

A liquid carbon (l-C) sample is generated through constant volume heating exposing an amorphous carbon foil to an intense ultrashort laser pulse. Time-resolved x-ray absorption spectroscopy at the C K edge is used to monitor the dynamics of the melting process revealing a subpicosecond rearrangement of the electronic structure associated with a sudden change of the C bonding hybridization. The obtained l-C sample, resulting from a nonthermal melting mechanism, reaches a transient equilibrium condition with a temperature of about 14 200 K and pressure in the order of 0.5 Mbar in about 0.3 ps, prior to hydrodynamic expansion. A detailed analysis of the atomic and electronic structure in solid-density l-C based on time-resolved x-ray absorption spectroscopy and theoretical simulations is presented. The method can be fruitfully used for extending the experimental investigation of the C phase diagram in a vast unexplored region covering the 10^{3}-10^{4} K temperature range with pressures up to 1 Mbar.

Epidemiología y patrones de sensibilidad a los antimicrobianos de microorganismos aislados de hemocultivos en niños con leucemia aguda / Epidemiology and sensitivity patterns of antimicrobials in microorganisms isolated in blood cultures of children with acute leukemia

Las infecciones bacterianas son una de las principales causas de morbimortalidad en los niños con cáncer. Nuestro objetivo fue describir y comparar las características clínicas y los microorganismos causantes de bacteriemias con su sensibilidad antimicrobiana en niños con diagnóstico de LLA y LMA. Se realizó un estudio observacional, descriptivo entre julio-2016 y junio-2018. Se incluyeron todos los episodios de bacteriemia (EpB) en pacientes de 0 a 18 años con diagnóstico de LLA y LMA. Se documentaron datos epidemiológicos y demográficos de los pacientes y datos microbiológicos de los aislamientos de hemocultivos positivos. Se utilizó stata13. Se incluyeron 258 EpB en 167 pacientes; el 55% eran varones. La mediana de edad fue 81 meses (RIC 39-130). En 215 EpB (83%) se registró la presencia de algún tipo de catéter; neutropenia en 193 EpB (75%), neutropenia severa en 98/258 EpB (38%). Se pudo determinar el foco clínico en 152 EpB (59%). Ciento diez pacientes tenían LLA y 57 LMA. En LLA predominaron las enterobacterias, en LMA los cocos gram positivos. Se observó asociación entre LMA y estreptococos del grupo Viridans (p<0,01) y entre LLA y P.aeruginosa (p 0,01). Con respecto a la sensibilidad hubo 11% y 17% de bacilos negativos multirresistentes en LLA y LMA respectivamente. Todos los estafilococos coagulasa negativos fueron meticilino resistentes. La mayoría de los pacientes tenía algún tipo de catéter y neutropenia. Se observó un predominio de enterobacterias con bajos niveles de resistencia antibiótica. Estos resultados son importantes para conocer la epidemiología local y establecer tratamientos empíricos adecuados (AU)

Bacterial infections are one of the main causes of morbidity and mortality in children with cancer. Our aim was to describe and compare the clinical features and bacteremia-causing microorganisms together with their antimicrobial sensitivity in acute lymphocytic (ALL) and acute myelocytic leukemia (AML). A descriptive observational study was conducted between July 2016 and June 2018. All episodes of bacteremia (EpB) in patients between 0 and 18 years of age with ALL and AML were included. All epidemiological and demographic data of the patients and microbiological information of the isolates of the positive blood cultures were recorded. For statistical analysis stata13 was used. Overall 258 EpB in 167 patients were included; 55% were boys. Median age was 81 months (IQR 39-130). In 215 EpB (83%) some type of catheter was involved; neutropenia was observed in 193 EpB (75%) and severe neutropenia in 98/258 EpB (38%). A clinical focus could be determined in 152 EpB (59%). Of all patients, 110 had ALL and 57 AML. The predominant micro-organisms were enterobacteria in ALL and gram-positive cocci in AML. An association was observed between AML and the viridans group of streptococci (p<0.01) and between ALL and P. aeruginosa (p 0.01). Regarding sensitivity, there were 11% and 17% of multiresistant negative bacilli in ALL and AML, respectively. All coagulase-negative staphylococci weer methicillin resistant. The majority of patients had some type of catheter and neutropenia. Predominance of enterobacteria with low levels of resistance to antibiotics was observed. These results are important to understand the local epidemiology and establish adequate empirical therapies (AU)

Ceria-Doped Titania Nanoparticles as Drug Delivery System.

The development of new devices at the nanoscale level, as therapeutic support in medical practice, has facilitated the development of drug delivery systems (DDSs) based on nanoparticles. This enables the transport of an effective dose of therapeutic agents to target cells or tissues, with no collateral damage to healthy cells. Owing to their unique properties, nanoparticles doped with rare earths have demonstrated the potential of being used as a DDS of drug molecules to target cells or tissues. In the present work, ceria-doped titania nanoparticles (CeO2/TiO2NPs) were used to form the DNR-CeO2/TiO2NPs complex as a DDS of daunorubicin (DNR), which was tested in a B-lymphocyte cell culture. The CeO2/TiO2NPs were synthesized via the sol-gel process in a microemulsion of reverse micelle. In general, the results indicated that the nanoparticles presented good biocompatibility and load efficiency superior to that reported in other investigations for pure titania nanoparticles, suggesting that the CeO2/TiO2NPs increased intracellular accumulation of the drug. These results indicate that a delivery strategy using CeO2/TiO2NPs is a promising approach in the medical field, particularly in anticancer therapies.

Complications of shoulder arthroplasty: added value of SPECT/CT imaging. / Complicaciones de las prótesis de hombro: valor añadido de la imagen SPECT/TC.

The incidence of prosthetic shoulder replacements has increased considerably in recent years, as well as the complications derived from the procedure. The correct diagnosis of each type of complication is essential for therapeutic decision making, which is currently based on the information provided by radiological and nuclear medicine imaging. Nevertheless, both techniques have intrinsic limitations that could be mostly overcome with the advent of the hybrid SPECT/CT imaging, which is set to play a fundamental role in the evaluation of shoulder prostheses.

Correlated response in body condition and energy mobilisation in rabbits selected for litter size variability.

A divergent selection experiment on litter size variability (high and low lines) was performed in rabbits over seven generations. The aim of this study was to evaluate the correlated responses to selection in body condition and fat reserves mobilisation. Litter size variability was estimated as phenotypic variance of litter size within female after correcting for the year-season and the parity-lactation status effects. A total of 226 females were used in this study, of which 158 females were used to measure body condition and energy mobilisation. Body condition was measured as BW and perirenal fat thickness. Females were stimulated with the adrenergic isoproterenol. Mobilisation capacity of fat reserves was measured by the lipolytic potential, defined as the increment in non-esterified fatty acids (NEFA) levels from basal concentration until adrenergic stimulation at mating, delivery and 10 days after delivery of the second reproductive cycle. Females were classified as survivor or non-survivor when they were culled for sanitary reasons or died before the third kindling. Data were analysed using Bayesian methodology. Survivor females presented higher BW than the non-survivor females at delivery (238 g, P=1.00) and 10 days after delivery (276 g, P=1.00). They also showed higher perirenal fat thickness at 10 days after delivery (0.62 mm, P=1.00). At delivery, basal NEFA levels was lower in survivor than non-survivor females (-0.18 mmol/l, P=1.00), but their lipolytic potential (∆NEFA) was higher (0.08 mmol/l, P=0.94). Body weight was similar between lines in survivor females. Perirenal fat thickness was lower in the high line than in the low line at delivery (-0.23 mm, P=0.90) and 10 days after delivery (-0.28 mm, P=0.92). The high line exhibited higher NEFA (0.10 mmol/l, P=0.93) and lower ∆NEFA (-0.08 mmol/l, P=0.92) than the low line at delivery. The low line showed a favourable correlated response to selection on body condition and fat reserves mobilisation. In conclusion, the low line selected for litter size variability seems to adapt better to adverse conditions, as it has a greater capacity to mobilise energy reserves at delivery than the high line. Females that adequately manage their body reserves and perform energy mobilisation correctly have a lower risk of dying or being culled.

Assessment of 68Ga-PSMA-11 PET positivity predictive factors in prostate cancer. / Valoración de factores predictivos de positividad en PET con 68Ga-PSMA-11 en el cáncer de próstata.

PURPOSE: Positron emission tomography (PET) studies with 68Ga-PSMA-11 (68Ga-HBED-CC-PSMA) have earned the attention of researchers, due to overexpression of PSMA in the tumoral tissues of prostate cancer. Our aim was to analyse the potential benefit of this radiotracer in the biochemical relapse of prostate cancer. MATERIAL AND METHODS: This retrospective analysis included 53 studies, performed on 50 male prostate cancer patients referred due to biochemical recurrence. In all cases, previous imaging techniques were negative or inconclusive. RESULTS: Of the 53 studies, 36 (68%) were positive. Significant differences were found between the positive and negative PET groups in Gleason's scale, PSA levels, PSAdt, late acquisition and the administration of androgen deprivation therapy during treatment (P<.05). Regarding PSA levels, 10 (48%) of the 21 patients with PSA<1ng/ml, obtained a pathological PET result. When the PSAdt was below six months, 86.7% of the patients obtained an abnormal PET. In the multivariate analysis, only Gleason's scale was associated independently with an abnormal PET result. CONCLUSIONS: 68Ga-PSMA-11 PET shows a high disease detection rate in patients where other techniques showed negative or doubtful images. Almost 50% of patients with prostate cancer biochemical recurrence and low PSA levels (<1ng/ml) have active disease on 68Ga-PSMA-11 PET, precisely where other radiotracers lack sensitivity.

Bacteriemia por Pseudomonas aeruginosa (PAE) en niños / Pseudomonas aeruginosa-associated bacteremia en children

Introducción. La bacteriemia por Pseudomonas aeruginosa (PAE) en niños es infrecuente. Objetivo.Describir las características epidemiológicas, clínicas, microbiológicas y evolutivas en niños con bacteriemia por PAE. Métodos. Estudio de cohorte retrospectivo. Resultados. Se incluyeron 100 pacientes (p). La mediana de edad fue de 27 meses (RIC 6-88).Tenían enfermedad de base: 93 p (93%) y 36 de ellos estaban neutropénicos. Ochenta y cinco p (85%) habían recibido antibióticos en el último mes, 60 (60%) tuvieron procedimientos invasivos previos y 81 (81%) tuvieron internaciones previas. Ingresaron con shock séptico 42 p (42%), 56 p (56%) fueron admitidos en unidad de cuidados intensivos (UCI) y 49 (49%) requirieron ventilación mecánica (VM). La bacteriemia fue primaria en 17 p (17%); asociada a catéter en 15 p (15%) y secundaria en 68 p (68%). El foco más frecuente fue mucocutáneo, 21 p, seguido por el pulmonar, 20 p. El tratamiento empírico fue adecuado en 84 p (84%). La resistencia a uno o más grupos de antibióticos se dio en el 38% de los casos, 11% fueron multirresistentes y 15% fueron resistentes sólo a carbapenemes. Fallecieron 31 p (31%). Pseudomonas aeruginosa resistente a carbapenemes en forma exclusiva o combinada con otros antibióticos se relacionó en esta serie a exposición previa a antibióticos, (p≤0,03), tratamiento empírico inicial inadecuado (p≤0,006) y mayor mortalidad (p≤0,01), prolongación de la internación y del tiempo de tratamiento (p≤0,001)

Introduction. Pseudomonas aeruginosa (PAE) associated bacteremia is uncommon in children. Objective. To describe the epidemiological, clinical, and microbiological features and outcome in children with PAE-associated bacteremia. Methods. A retrospective cohort study. Results. 100 patients (p) were included. Median age was 27 months (IQR 6-88). Overall 93 p (93%) had an underlying disease, 36 of whom had neutropenia. Eighty-five p (85%) had received antibiotics over the previous month, 60 (60%) had undergone previous invasive procedures, and 81 (81%) had been previously admitted. Forty-two p (42%) were admitted because of septic shock, 56 p (56%) were admitted to the intensive care unit (ICU), and 49 (49%) required mechanical ventilation (MV). Seventeen p (17%) had primary bacteremia, 15 p (15%) had catheter-related bacteremia, and 68 p (68%) had secondary bacteremia. The most common focus was mucocutaneous (21 p), followed by pulmonary (20 p). Emperical treatment was adequate in 84 p (84%). Resistance to one or more groups of antibiotics was observed in 38% of the cases; 11% were multiresistant and 15% were only resistant to carbapenems. Thirty-one p (31%) died. In our series, Pseudomonas aeruginosa resistant to carbapenems only or combined with other antibiotics was associated with previous exposition to antibiotics (p≤0.03), inadequate initial emperical treatment (p≤0.006), and higher mortality (p≤0.01), and longer hospital stay and treatment duration (p≤0.001)