Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, lymphocyte to monocyte ratio and Systemic Inflammatory Index in sexually transmitted diseases.

Introduction: Hematologic biomarkers of inflammation may serve as valuable adjuncts in clinical practice, aiding in several aspects such as differential diagnosis, prognostic assessment for patient stratification and monitoring the efficacy of antimicrobial therapy. The aim of this study was to evaluate the efficacy of Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR), Lymphocyte to Monocyte Ratio (LMR), and Systemic Inflammatory Index (SII) in predicting bacterial sexually transmitted infections (STI). Methods: This prospective study was conducted in the north-west region of Romania and included patients from several medical special units such as dermatology, obstetrics-gynecology, urology, and general practice. The study group comprised patients with a high suspicion of STI, while the control group consisted of healthy subjects. Quantitative data are presented as medians (interquartile ranges). Results: The median values of SII, NLR, and SIRI were higher in the group of subjects with sexually transmitted diseases compared to the control group [604.06 (432.36 - 880.02) vs. 556.89 (388.63 - 874.19); 2.61 (1.57 - 3.3) vs. 2.29 (1.66 - 3.26); and 0.95 (0.53 - 1.52) vs. 0.89 (0.67 - 1.34)]. Regarding PLR, the median values were lower in the group of subjects with sexually transmitted diseases compared to the control group [138.1 (99.19 - 169.6) vs. 140.65 (117 - 190.32)]. As for LMR, the median values were equal between the two groups [4.64 (3.74 - 6.11) vs. 4.64 (3.75 - 5.45)]. Nevertheless, the differences did not reach the significance level. Conclusion: Our study suggests that inflammatory biomarkers might aid in detecting bacterial STIs, but their significance was not statistically confirmed. Further research on alternative laboratory tests is needed for improved STI diagnosis and management.

Dyadic Adjustment of Couples and State Anxiety in Patients Tested for Sexually Transmitted Infections.

Background: While existing literature addresses the psychological impact of HIV, there is a notable gap in data regarding other sexually transmitted infections (STIs). This study aims to fill this gap by evaluating the association between STIs, the psychological profile of patients as measured by anxiety levels, and the impact on couple adaptability. Methods: A prospective investigation was conducted in Romania, from November 2021, including individuals with high suspicion of STI and healthy controls. Data collection comprised a questionnaire, the Dyadic Adjustment Scale (DAS), and State-Trait Anxiety Inventory (STAI Y-1). Statistical methods, including multivariate logistic and linear regressions, were used to carry out the analyses. Results: The participant cohort consisted of 441 individuals. STI participants exhibited consistently lower DAS scores, notably in dyadic adaptability (DA) (p = 0.031), dyadic satisfaction (DS) (p = 0.006), and affectional expression (AE) (p = 0.016). Multivariate logistic regression with adjustment for confounders confirmed a significant association between STIs and atypical DAS responses (2.56-fold increase). STAI T scores were significantly higher in the STI suspected group (p < 0.01), remaining robust after adjusting for confounders in a multiple linear regression model. Conclusions: Our prospectively designed study highlights the mental health repercussions associated with STIs. This is evident through the diminished DAS scores and heightened STAI Y-1 scores observed in individuals with suspected STIs.

Chlamydia trachomatis and the HLA involvement in the development of infection and disease: a narrative review.

Introduction: CT (Chlamydia trachomatis) is among the most common pathogens leading to sexually transmitted diseases. Considering the uncertain mechanism by which HLA polymorphisms influence the CT infection, reinfection, comorbidities or evolution and because there is no consensus regarding the alleles involved in the pathogenesis of the infection, we considered necessary to perform a review to summarize the current knowledge of HLA related to CT. Methods: Pubmed was researched using key terms. Out of the 198 results found, we analyzed articles of all types which describe how the MHC, through HLA alleles, participates in the different stages of CT penetration in the body, including studies about cells or other molecules involved in the process. Results: Almost 40% of the variation in the clinical course of CT infection depends on host genetic factors. There are haplotypes that influence the infection susceptibility/resistance, haplotypes that are involved in the recurrence of the infection, haplotypes that are related to tubal infertility, pelvic inflammatory disease development or trachoma. Antibody to Chsp60 (influenced by MHC genes) has been observed to correlate with late tissue-damaging sequelae. Toll-like receptors were found to increase the susceptibility to CT. The association of HLA-B27 creates susceptibility of reactive arthritis in the organisms infected by CT, but does not influence the carriage of CT. Conclusion: We identified HLA haplotypes belonging both to MHC class l and ll, which influence different stages of CT infection. Genetic risk factors still need research, especially on Caucasians. Studies are moving towards designing a safe and effective vaccine.

Quantifying and addressing the prevalence and bias of study designs in the environmental and social sciences.

Building trust in science and evidence-based decision-making depends heavily on the credibility of studies and their findings. Researchers employ many different study designs that vary in their risk of bias to evaluate the true effect of interventions or impacts. Here, we empirically quantify, on a large scale, the prevalence of different study designs and the magnitude of bias in their estimates. Randomised designs and controlled observational designs with pre-intervention sampling were used by just 23% of intervention studies in biodiversity conservation, and 36% of intervention studies in social science. We demonstrate, through pairwise within-study comparisons across 49 environmental datasets, that these types of designs usually give less biased estimates than simpler observational designs. We propose a model-based approach to combine study estimates that may suffer from different levels of study design bias, discuss the implications for evidence synthesis, and how to facilitate the use of more credible study designs.

[Validation of a high sensitive troponin 99th percentile obtained in a general hospital]. / Validación de percentil 99 de troponina ultrasensible obtenido en la población de un hospital general.

Introduction: High sensitivity cardiac Troponin T (hs-cTnT) dosage is recommended for myocardial infarction diagnosis, by applying the 99th percentile obtained from a healthy population by the manufacturer. The objective is to validate the 99th percentile in a population from our hospital (99L), compared with the manufacturer´s 99th percentile (99F) by using coronary angiography as gold standard. Materials and Methods: Retrospective analysis of every hs-cTnT (Roche) obtained from patients admitted with acute coronary syndromes (ACS) who underwent coronary angiography between 2015 and 2018. Results: 415 patients were included for analysis (118 females, 64.2 yo). 99F sensitivity (Sn) for significant coronary artery disease (stenosis >70%) was 83.6%, with a specificity (Sp) of 44.5%. Positive predictive value (PPV) and negative predictive value (NPV) were 77% and 55% respectively. 99L Sn was 69.7% and Sp 58.6%. PPV was 79% and NPV 46%. ROC curve was 0.641 for 99F and 0.641 for 99L. Conclusion: Given the importance of hs-cTnT in ACS diagnosis, the 99F should be the preferred upper reference limit since the sensitivity is better, although lower compared to prior studies.

Introducción: El dosaje de troponina ultrasensible (TnT US) se recomienda para el diagnóstico de infarto de miocardio, para lo cual se utiliza como punto de corte el percentil 99 (p99) obtenido por el fabricante (99F) en población sana. El objetivo de este estudio es validar el p99 obtenido en la población de este hospital (99L) frente al 99F, utilizando la cinecoronariografía (CCG) como gold standard. Materiales y Métodos: análisis retrospectivo de TnT US Roche realizada a todos los pacientes que ingresaron por SCA (síndrome coronario agudo) a los que se les realizó CCG entre 2015 y 2018. Se utilizó para el procesamiento estadístico el programa IBM SPSS Statistics 24 y tablas de sensibilidad y especificidad para métodos diagnósticos (EviCardio). Resultados: se incluyeron 415 pacientes, 118 de sexo femenino, con edad de 64,2 ± 12,5 años. La sensibilidad del 99F para diagnóstico de enfermedad coronaria severa (obstrucción ≥ 70%) fue de 83,6% y la especificidad, 44,5%. El valor predictivo positivo (VPP) fue de 77% y el negativo (VPN) 55%. La sensibilidad del 99L se calculó en 69,7% y la especificidad, 58,6%. El VPP fue 79% y el VPN 46%. El ABC (área bajo la curva) resultó ser 0,641 para el 99Fy 0,641 para el 99L Conclusiones: Debido a la importancia de la sensibilidad en el uso de la TnT US como herramienta diagnóstica ante la sospecha de SCA, debemos seguir utilizando el 99F ya que mostró mayor sensibilidad que 99L (aunque menor a la reportada en estudios previos).

[Effectiveness of transthoracic echocardiogram in patent foramen ovale diagnosis. Systematic review of last ten years.] / Eficacia del ecocardiograma transtorácico para el diagnóstico de foramen oval permeable. Revisión sistemática de los últimos diez años.

Background: Transesophageal echo (TEE) bubble study is the current gold standard for patent foramen ovale (PFO) diagnosis, but it has the disadvantage of being semi-invasive and not exempted from risks. The aim of this study was to determine the accuracy of TTE compared to TEE for PFO diagnosis. Methods and results: a systematic review was done on Medline with the terms "transthoracic echocardiography, transesophageal echocardiography, patent foramen ovale, diagnosis" yielding published literature of the last ten years. The search was completed in february 2018. Of 715 articles, 10 were analyzed. The total of patients were 1268 (mean age of 47 years +/-14) with a global prevalence of PFO of 48%. The sensibility of ETT was 90 % (IC 95: 88 % - 92 %) and the specificity 92% (IC 95: 89 % - 94 %). The positive predictive value was 93% (IC 95: 90 % - 94 %) and the negative predictive value 89 % (IC 95: 87 % - 91 %). The area under the curve and Q index value were 0,97 and 0,93 respectively. The positive and negative likelihood ratio were 18,989 and 0,072 respectively. Conclusion: The ETT shows a good specificity and sensibility for PFO diagnosis with last generation equipments, contrast use and valsalva maneuver; according to the analyzed studies.

Introducción: El ecocardiograma transesofágico (ETE) con burbujas es el estudio de referencia para el diagnóstico de foramen oval permeable (FOP), es semi-invasivo y no exento de riesgos. Nuestro objetivo fue determinar la eficacia del ecocardiograma transtorácico (ETT) para el diagnóstico de FOP, en comparación con el ETE. Métodos y resultados: Se realizó una búsqueda en MEDLINE de los últimos 10 años con las palabras claves: "ecocardiograma transtorácico, ecocardiograma transesofágico, foramen oval permeable, diagnóstico". La búsqueda se completó el 28 de Febrero de 2018. De 715 artículos, se seleccionaron 10 para analizar. El total de pacientes fue 1268, edad promedio de 47 años +/-14. La prevalencia global de FOP fue de 48%. La sensibilidad del ETT fue de 90% (IC 95: 88% - 92%) y la especificidad de 92% (IC 95: 89% - 94%). El valor predictivo positivo fue de 93% (IC 95: 90% - 94%) y el valor predictivo negativo de 89% (IC 95: 87% - 91%). El área bajo la curva y el índice Q fueron 0,97 y 0,93 respectivamente. El cociente de probabilidad positivo fue de 18,989 y el negativo de 0,072. Conclusión: El ETT muestra una buena especificidad y sensibilidad para el diagnóstico de FOP con equipos de última generación, uso de contraste y maniobra de Valsalva; según los estudios analizados.

Distribution and habitat preference of Ephemeroptera and Trichoptera in subtropical mountain streams: implications for monitoring and conservation.

The assessment of biotic-habitat relationships provides key information to predict biotic responses to perturbations and important tools for river management and monitoring. This study aimed to assess the spatial distribution of Ephemeroptera and Trichoptera in mountain streams of central Argentina. We evaluated the effect of seasonality and identified the variables conditioning the abundance of the assemblages and the habitat with the highest taxonomic richness. Sampling was carried out in four streams (Carcarañá River basin) during high and low water periods. Three lotic habitats were sampled: riffles, coarse substrate runs, and fine substrate runs; and physicochemical and habitat variables were measured. We found differences in assemblage composition, among the 25 genera of Ephemeroptera and Trichoptera, at the habitat level. The most important variables affecting distribution patterns were substrate and flow type, but macroalgae and organic matter (twigs, leaves, and detritus) were also important predictors. Riffles maintained the highest richness but when considering only the Ephemeroptera taxa, fine substrate runs emerged also as an important habitat for these taxa. Our study provided valuable ecological information related to habitat preference of taxa with a key role in stream functioning and of great usefulness for the monitoring of lotic systems.

Anuran tadpoles inhabiting a fluoride-rich stream: diets and morphological indicators.

We in situ assessed the influence of natural fluoride concentrations in lotic freshwater ecosystems on diet and morphology of Boana cordobae tadpoles. Two streams were sampled in Argentina: Los Vallecitos stream (LF-LV) and Los Cerros Negros stream (HF-CN) with low and high fluoride levels, respectively. We captured tadpoles of B. cordobae in each stream using nets. Body weight (BW), total length (TL) and body condition (BC) of tadpoles was registered. Food items were identified to genus level and assigned to functional traits. Tadpoles showed significant differences in TL between streams, with smaller individuals in HF-CN, while did not show differences in BW and BC. The diet of tadpoles consisted mostly of microalgae. In tadpoles from HF-CN stream the proportion of cyanobacteria was lower than tadpoles from LF-LV. In relation to functional traits, small algae, high profile and colonial algae were more abundant in HF-CN. Algae attached by pads showed a higher proportion in HF-CN diets and stalked algae were more abundant in LF-LV. The differences in TL and diet of tadpoles can be attributed to differences in algal community composition, with genera that are affected by high concentrations of natural fluoride; for example cyanobacteria. The low algal richness registered in HF-CN stream does not affect the physiological state of the tadpoles, possibly because of a higher algal density in HF-CN diets. However, in further studies it would be important to evaluate the population status of B. cordobae from the HF-CN, because a small body length of tadpoles could have consequences at the population level.