Utilización del equipo de protección personal e infección por SARS-CoV-2 en trabajadores del sector salud / Use of Personal Protective Equipment and SARS-Cov-2 Infection Among Healthcare Workers

Introducción: Los trabajadores de salud son los primeros en enfrentarse a brotes epidemiológicos, como el causado con el agente infeccioso emergente síndrome agudo respiratorio severo de tipo 2 (SARS-CoV-2). El cumplimiento de las medidas de protección es primordial para evitar el contagio. Para ello se implementó el uso se equipos protección personal (EPP)Método: Difusión de encuesta voluntaria y anónima entre los empleados de centros sanitarios. (Datos obtenidos desde 6 de noviembre 2020 al 6 febrero de 2021). Se recibieron 443 respuestas validas con las que se evaluó la correcta utilización y acceso al EPP, se midió los casos de enfermedad del coronavirus 2019 (COVID-19) y el efecto de la pandemia en el personal del sector salud. Diseño del estudio descriptivo, prospectivo y transversal Resultados: Mayor percepción de los erro-res cometidos (x2=161,663 con una p=0,000), probabilidad de contagio (x2=81,118 con una p=0,024) y duración síntomas (x2=440,955 con una p=0,001) según la profesión. Existe relación entre la residencia y nacionalidad del trabajador y la infección por SARS-CoV-2 x2=72,630 con una p=0,020 y una x2=61,247 con una p=0,132. Hay relación entre el número de ítems de EPP usado y la infección por SARS-CoV-2 (x2=38,373 con una p=0,032). Mayor riesgo de contagio según el departamento: residencias (x2=10,223 con una p=0,006), las unidades de pacientes con problemas respiratorios (x2=6,050 con una p=0,049) y las unida-des de paliativos (x2=7,795 con una p=0,020).Conclusiones: Los sanitarios no han estado debidamente protegidos contra la infección por SARS-CoV-2, sobre todo al principio de la pandemia. (AU)

Background: Frontline healthcare workers are the first to face epidemiological outbreaks, such as the caused by the emerging infectious agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compliance with protective measures is essential to avoid the infection. Therefore, use of personal protection equipment (PPE) was implemented.Method: Dissemination of a voluntary and anon-ymous survey among employees in healthcare centers. (Data obtained from 6th November 2020 to 6th February 2021). 443 valid answers were re-ceived. The correct use and access to PPE was evaluated, cases of coronavirus disease 2019 (COVID-19) were measured as well as the effect of the pandemic on healthcare workers.The design of the study is cross-sectional, de-scriptive and prospective.Results: Greater perception of the errors com-mitted (x2=161.663 with a p=0.000), greater probability of contagion (x2= 81.118 with a p=0.024) and longer duration of symptoms (x2= 440.955 with a p= 0.001) according to the pro-fession.Relationship between the residence and nation-ality of the healthcare worker with the infection by SARS-CoV-2 x2=72.630 with a p=0.020 and x2=61.247 with a p=0.132. Relationship between the number of PPE used and SARS-CoV-2 infec-tion (x2= 38.373 with a p= 0.032). Greater risk of contagion according to the workplace: care homes (x2= 10.223 with a p= 0.006), respiratory wards (x2=6.050 with a p= 0.049) and palliative care units (x2= 7.795 with a p=0.020).Conclusions: Healthcare workers have not been adequately protected against the SARS-CoV-2 infection, especially at the beginning of the pandemic. (AU)

Association of serum soluble Fas concentrations and mortality of septic patients.

INTRODUCTION: Scarce data on Fas, one of the main receptors that activates the apoptosis extrinsic pathway, in septic patients exists. Higher blood soluble Fas (sFas) concentrations in non-survivor septic patients compared with survivors have been found in small studies; however, the association of blood sFas concentrations with mortality controlling for sepsis severity has not been stablished due to this small sample size in those studies. Thus, our main objective study was to determine whether an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists. METHODS: We included septic patients in this observational and prospective study carried out in three Spanish Intensive Care Units. We obtained serum samples at sepsis diagnosis sepsis for sFas levels determination. RESULTS: Thirty-day non-surviving patients (n=85) compared to surviving patients (n=151) had higher serum sFas levels (p<0.001). We found in multiple logistic regression analysis an association of serum sFas levels with mortality controlling for age and SOFA (OR=1.004; 95% CI=1.002-1.006; p<0.001), and for age and APACHE-II (OR=1.004; 95% CI=1.002-1.006; p<0.001). Serum sFas levels showed and area under the curve for mortality prediction of 71% (95% CI=65-71%; p<0.001). Kaplan-Meier analysis showed higher mortality rate in patients with serum sFas levels>83.5ng/mL (Hazard ratio=3.2; 95% CI=2.1-5.0; p<0.001). CONCLUSIONS: That an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists was our main new finding study.

Association of serum soluble Fas concentrations and mortality of septic patients / Asociación de concentraciones séricas de soluble Fas y mortalidad de pacientes sépticos

Introduction: Scarce data on Fas, one of the main receptors that activates the apoptosis extrinsic pathway, in septic patients exists. Higher blood soluble Fas (sFas) concentrations in non-survivor septic patients compared with survivors have been found in small studies; however, the association of blood sFas concentrations with mortality controlling for sepsis severity has not been stablished due to this small sample size in those studies. Thus, our main objective study was to determine whether an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists. Methods: We included septic patients in this observational and prospective study carried out in three Spanish Intensive Care Units. We obtained serum samples at sepsis diagnosis sepsis for sFas levels determination. Results: Thirty-day non-surviving patients (n=85) compared to surviving patients (n=151) had higher serum sFas levels (p<0.001). We found in multiple logistic regression analysis an association of serum sFas levels with mortality controlling for age and SOFA (OR=1.004; 95% CI=1.002–1.006; p<0.001), and for age and APACHE-II (OR=1.004; 95% CI=1.002–1.006; p<0.001). Serum sFas levels showed and area under the curve for mortality prediction of 71% (95% CI=65–71%; p<0.001). Kaplan–Meier analysis showed higher mortality rate in patients with serum sFas levels>83.5ng/mL (Hazard ratio=3.2; 95% CI=2.1–5.0; p<0.001). Conclusions: That an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists was our main new finding study.(AU)

Introducción: Existen pocos datos sobre Fas, uno de los principales receptores que activan la vía extrínseca de la apoptosis, en pacientes septicos. En estudios de pequeño tamaño muestral se han encontrado altas concentraciones sanguíneas de soluble Fas (sFas) en pacientes sépticos fallecidos en comparación con supervivientes; sin embargo, no ha sido establecida la asociación de concentraciones sanguíneas de sFas con mortalidad controlando por la gravedad de la sepsis. Por lo tanto, el principal objetivo de nuestro estudio fue determinar si existe una asociación entre concentraciones sanguíneas de sFas y la mortalidad en sepsis controlando por la gravedad. Métodos: Incluímos pacientes sépticos en este estudio observacional y prospectivo realizado en tres Unidades de Cuidados Intensivos españolas. Obtuvimos muestras de suero en el momento del diagnóstico de la sepsis para la determinación de concentraciones de sFas. Resultados: Los pacientes fallecidos durante los primeros treinta días (n=85) comparados con los supervivientes (n=151) tuvieron mayores concentraciones séricas de sFas (p<0,001). Se encontró una asociación de concentraciones séricas de sFas con mortalidad controlando por edad y SOFA (OR=1,004; 95% IC=1,002-1,006; p < 0,001), y por edad y APACHE-II (OR=1,004; 95% IC=1,002-1,006; p < 0,001). Las concentraciones séricas de sFas mostraron un área bajo la curva para la predicción de mortalidad del 71% (IC 95%=65%-71%; p < 0,001). El análisis Kaplan-Meier mostró una mayor mortalidad en los pacientes con concentraciones séricas de sFas > 83,5 ng/mL (Hazard ratio=3,2; 95% IC=2,1-5,0; p < 0,001). Conclusiones: La asociación entre concentraciones sanguíneas de sFas y la mortalidad en sepsis controlando por la gravedad fue el principal nuevo hallazgo de nuestro estudio.(AU)

Association of serum soluble Fas concentrations and mortality of septic patients.

INTRODUCTION: Scarce data on Fas, one of the main receptors that activates the apoptosis extrinsic pathway, in septic patients exists. Higher blood soluble Fas (sFas) concentrations in non-survivor septic patients compared with survivors have been found in small studies; however, the association of blood sFas concentrations with mortality controlling for sepsis severity has not been stablished due to this small sample size in those studies. Thus, our main objective study was to determine whether an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists. METHODS: We included septic patients in this observational and prospective study carried out in three Spanish Intensive Care Units. We obtained serum samples at sepsis diagnosis sepsis for sFas levels determination. RESULTS: Thirty-day non-surviving patients (n=85) compared to surviving patients (n=151) had higher serum sFas levels (p<0.001). We found in multiple logistic regression analysis an association of serum sFas levels with mortality controlling for age and SOFA (OR=1.004; 95% CI=1.002-1.006; p<0.001), and for age and APACHE-II (OR=1.004; 95% CI=1.002-1.006; p<0.001). Serum sFas levels showed and area under the curve for mortality prediction of 71% (95% CI=65-71%; p<0.001). Kaplan-Meier analysis showed higher mortality rate in patients with serum sFas levels>83.5ng/mL (Hazard ratio=3.2; 95% CI=2.1-5.0; p<0.001). CONCLUSIONS: That an association between blood sFas concentrations and sepsis mortality controlling for sepsis severity exists was our main new finding study.

Association between serum soluble CD40 ligand levels and mortality in patients with severe sepsis.

INTRODUCTION: CD40 Ligand (CD40L) and its soluble counterpart (sCD40L) are proteins that exhibit prothrombotic and proinflammatory properties on binding to their cell surface receptor CD40. The results of small clinical studies suggest that sCD40L levels could play a role in sepsis; however, there are no data on the association between sCD40L levels and mortality of septic patients. Thus, the aim of this study was to determine whether circulating sCD40L levels could be a marker of adverse outcome in a large cohort of patients with severe sepsis. METHODS: This was a multicenter, observational and prospective study carried out in six Spanish intensive care units. Serum levels of sCD40L, tumour necrosis factor-alpha and interleukin-10, and plasma levels of tissue factor were measured in 186 patients with severe sepsis at the time of diagnosis. Serum sCD40L was also measured in 50 age- and sex-matched controls. Survival at 30 days was used as the endpoint. RESULTS: Circulating sCD40L levels were significantly higher in septic patients than in controls (P = 0.01), and in non-survivors (n = 62) compared to survivors (n = 124) (P = 0.04). However, the levels of CD40L were not different regarding sepsis severity. Logistic regression analysis showed that sCD40L levels >3.5 ng/mL were associated with higher mortality at 30 days (odds ratio = 2.89; 95% confidence interval = 1.37 to 6.07; P = 0.005). The area under the curve of sCD40L levels >3.5 ng/mL as predictor of mortality at 30 days was 0.58 (95% CI = 0.51 to 0.65; P = 0.03). CONCLUSIONS: In conclusion, circulating sCD40L levels are increased in septic patients and are independently associated with mortality in these patients; thus, its modulation could represent an attractive therapeutic target.

Temperature increase prevails over acidification in gene expression modulation of amastigote differentiation in Leishmania infantum.

BACKGROUND: The extracellular promastigote and the intracellular amastigote stages alternate in the digenetic life cycle of the trypanosomatid parasite Leishmania. Amastigotes develop inside parasitophorous vacuoles of mammalian phagocytes, where they tolerate extreme environmental conditions. Temperature increase and pH decrease are crucial factors in the multifactorial differentiation process of promastigotes to amastigotes. Although expression profiling approaches for axenic, cell culture- and lesion-derived amastigotes have already been reported, the specific influence of temperature increase and acidification of the environment on developmental regulation of genes has not been previously studied. For the first time, we have used custom L. infantum genomic DNA microarrays to compare the isolated and the combined effects of both factors on the transcriptome. RESULTS: Immunofluorescence analysis of promastigote-specific glycoprotein gp46 and expression modulation analysis of the amastigote-specific A2 gene have revealed that concomitant exposure to temperature increase and acidification leads to amastigote-like forms. The temperature-induced gene expression profile in the absence of pH variation resembles the profile obtained under combined exposure to both factors unlike that obtained for exposure to acidification alone. In fact, the subsequent fold change-based global iterative hierarchical clustering analysis supports these findings. CONCLUSIONS: The specific influence of temperature and pH on the differential regulation of genes described in this study and the evidence provided by clustering analysis is consistent with the predominant role of temperature increase over extracellular pH decrease in the amastigote differentiation process, which provides new insights into Leishmania physiology.

The 2005 MARTE Robotic Drilling Experiment in Río Tinto, Spain: objectives, approach, and results of a simulated mission to search for life in the Martian subsurface.

The Mars Astrobiology Research and Technology Experiment (MARTE) simulated a robotic drilling mission to search for subsurface life on Mars. The drill site was on Peña de Hierro near the headwaters of the Río Tinto river (southwest Spain), on a deposit that includes massive sulfides and their gossanized remains that resemble some iron and sulfur minerals found on Mars. The mission used a fluidless, 10-axis, autonomous coring drill mounted on a simulated lander. Cores were faced; then instruments collected color wide-angle context images, color microscopic images, visible-near infrared point spectra, and (lower resolution) visible-near infrared hyperspectral images. Cores were then stored for further processing or ejected. A borehole inspection system collected panoramic imaging and Raman spectra of borehole walls. Life detection was performed on full cores with an adenosine triphosphate luciferin-luciferase bioluminescence assay and on crushed core sections with SOLID2, an antibody array-based instrument. Two remotely located science teams analyzed the remote sensing data and chose subsample locations. In 30 days of operation, the drill penetrated to 6 m and collected 21 cores. Biosignatures were detected in 12 of 15 samples analyzed by SOLID2. Science teams correctly interpreted the nature of the deposits drilled as compared to the ground truth. This experiment shows that drilling to search for subsurface life on Mars is technically feasible and scientifically rewarding.