Synergy between pyroelectric and photovoltaic effects for optoelectronic nanoparticle manipulation.

The combined action of the pyroelectric (PY) and photovoltaic (PV) effects, exhibited by z-cut LiNbO3:Fe substrates, has been investigated for particle trapping and patterning applications. The novel hybrid procedure provides new possibilities and versatility to optoelectronic manipulation on LiNbO3 substrates. It has allowed obtaining periodic and arbitrary 2D patterns whose particle density distribution is correlated with the light intensity profile but can be tuned through ΔT according to the relative strength of the PV and PY effects. A relevant result is that the PY and PV contributions compete for a ΔT range of 1-20 °C, very accessible for experiments. Moreover, the synergy of the PY and PV has provided two additional remarkable applications: i) A method to measure the PV field, key magnitude for photovoltaic optoelectronic tweezers. Using this method, the minimum field needed to obtain a particle pattern has been determined, resulting relatively high, E~60 kV/cm, and so, requiring highly doped crystals when only using the PV effect. ii) An strategy combining the PY and PV to get particle patterning in samples inactive for PV trapping when the PV field value is under that threshold.

Changes in D1 but not D2 dopamine or mu-opioid receptor expression in limbic and motor structures after lateral hypothalamus electrical self-stimulation: A quantitative autoradiographic study.

Intracranial self-stimulation (ICSS) of the lateral hypothalamus (LH) is involved in the activation of neuroanatomical systems that are also associated with the processing of natural and other artificial rewarding stimuli. Specific components of this behavior (hedonic impact, learning, and motor behavior) may involve changes in different neurotransmitters, such as dopamine and opioids. In this study, quantitative autoradiography was used to examine changes in mu-opioid and D1/D2-dopamine receptor expression in various anatomical regions related to the motor and mesolimbic reward systems after intracranial self-stimulation of the LH. Results of the behavioral procedure and subsequent radiochemical assays show selective changes in D1 but not D2 or mu receptors in Accumbens-Shell, Ventral Pallidum, Caudate-Putamen, and Medial Globus Pallidus. These findings are discussed in relation to the different psychobiological components of the appetitive motivational system, identifying some dissociation among them, particularly with respect to the involvement of the D1-dopamine subsystem (but not D2 or mu receptors) in goal-directed behaviors.

[Sociodemographic characteristics and risk factors associated to significative bacteriuria in a Spanish health area]. / Características sociodemográficas y factores de riesgo asociados a las bacteriurias significativas en un área de salud del sudeste español.

OBJECTIVE: To determine the epidemiological characteristics of significative bacteriuria (SB) and their relationship with sociodemographic factors and to analyze risk factors in inpatients. METHODS: Cross-sectional descriptive study carried out on urine culture samples received between 2016-2020 in the Microbiology laboratory, differentiating between minors and adults. The dependent variable was the presence of SB and the independent variables were age, sex, year, type of sample and source of the sample. In urine cultures of inpatients, risk factors were evaluated from the Minimum Basic Data Set. RESULTS: A total of 68,587 valid records (96.3% of the total) were analyzed. 40.8% (95% CI: 40.4%-41.2%) of urine cultures in adults and 33.8% (95% CI: 32.9%-34.7%) in children were positive, with an incidence that ranged in adults between 18.2 cases/1,000 inhabitants in 2016 and 14.6 cases/1,000 inhabitants in 2020 and 21.1 and 8.4 cases/1,000 inhabitants respectively in minors. Positive urine cultures were more frequent in children from urban areas compared to rural areas (OR=1.37; p<0.01). In hospitalized adults, for each year of age the risk of SB increased by 2%, it was 36% higher in women, 18% higher in obese patients and 17% more frequent in patients with kidney disease, (p<0.01). No relationship was observed between SB and diagnosis of COVID-19. CONCLUSIONS: The sociodemographic characteristics of the population with SB in our health area are similar to those found in other geographical areas worldwide, observing a decreasing trend in incidence in the years studied. The frequency of SB in children is higher in urban areas.

Rapid discrimination of rewarding nutrient by the upper gastrointestinal tract.

When certain nutrients are injected into the stomachs of rats that are drinking one of two samples of nonnutrient, flavored water, the rats will (within a 10-minute session) choose the flavor paired with the nutrient. Such rewarding effects have obtained with predigested milk but not with similarly treated glucose or fresh milk. The results suggest the presence of rapidly acting, specialized, nutrient receptors in the upper gastrointestinal tract.

Evolution of the antibiotic-resistance of microorganisms causing urinary tract infections: A 4-year epidemiological surveillance study in a hospital population. / Evolución de la resistencia a antibióticos de microorganismos causantes de infecciones del tracto urinario: un estudio de vigilancia epidemiológica de 4 años en población hospitalaria.

BACKGROUND: Urinary tract infections (UTIs) are the leading cause of infection in hospitalised patients. In this study, we describe the most common pathogens involved in the development of UTIs in hospitalised patients, their antibiotic-sensitivity profile and the activity evolution of antibiotics in standard use for treating these infections. METHODS: We retrospectively assessed the results of cultures and antibiograms from urine samples from adult patients hospitalised in the Hospital Complex Virgen de la Nieves (Granada, Spain) with a microbiological confirmation of UTI between January 2013 and December 2016. RESULTS: We identified 4,347 microorganisms (3,969 bacteria and 378 yeasts). During the 4years of the study, Escherichia coli was the most common species isolated in both sexes; however, 62.9% of the UTIs were caused by other microorganisms. The presence of multiresistant microorganisms such as Acinetobacterspp. (1.2%) and extended-spectrum beta-lactamase-producing enterobacteria (10.0%) and carbapenemase-producing enterobacteria (0.3%) were also relevant findings. Imipenem, piperacillin-tazobactam and fosfomycin presented activity rates above 80%, considering all causal microorganisms of UTI, while the other tested antibiotics presented activity rates below 70%. CONCLUSION: Imipenem and piperacillin-tazobactam were the most active antibiotics in hospital use, which makes them first-line antibiotics in the empiric treatment of UTIs in this healthcare setting. The use of other antibiotics should be limited to conditions of demonstrated or highly probable sensitivity.

Anticoagulant treatment of medical patients with complex clinical conditions. / Tratamiento anticoagulante en pacientes médicos con situaciones clínicas complejas.

There is scarce available information on the treatment or prophylaxis with anticoagulant drugs of outpatients with medical diseases and complex clinical conditions. There are no clinical practice guidelines and/or specific recommendations for this patient subgroup, which are frequently treated by internists. Complex clinical conditions are those in which, due to comorbidity, age, vital prognosis or multiple treatment with drugs, a clinical situation arises of disease-disease, disease-drug or drug-drug interactions that is not included within the scenarios that commonly generate the scientific evidence. The objective of this narrative review is collecting and adapting of the clinical guidelines recommendations and systematic reviews to complex clinical conditions, in which the direct application of recommendations based on studies that do not include patients with this complexity and comorbidity could be problematic.

Use of genitofemoral and ilioinguinal and iliohypogastric nerve block during orchiectomy in a post-lung transplant patient. A case report. / Uso de bloqueo genitofemoral en combinación con bloqueo ilioinguinal e iliohipogástrico para orquiectomía en paciente postrasplantado pulmonar. A propósito de un caso.

The case is presented of a post-lung transplant patient, ASA III, proposed for orchiectomy due to testicular cancer. A combination of iliohypogastric (ILH), ilioinguinal (ILI) and genitofemoral (GF) nerve block together with sedation was used as anaesthetic technique. The inguinal area received sensory innervation mainly from ILI, ILH and GF nerves. The genital branch of the GF nerve supplies innervation to skin of the anterosuperior portion of the scrotum. When performing the echo-guided block of GF nerve, it is necessary to identify the spermatic cord, and administer the local anaesthetic on the inside and periphery of the cord. Peripheral nerve blocks are a valid option for complex patients. Its main advantage is the anaesthesia and analgesia level that it provides without the haemodynamic instability associated with general or neuraxial anaesthesia. GF nerve block provides hemi-scrotal anaesthesia, allowing manipulation and intervention in the inguinal-scrotal area, complementing the anaesthesia provided by ILI and ILH nerve blocks.

Historical bibliometric analysis of the top cited articles on vesicoureteral reflux 1950-2016, and incorporation of a novel impact index.

INTRODUCTION AND OBJECTIVES: Vesicoureteral reflux (VUR) has been one of the defining conditions unique to pediatric urology since its inception. The clinical implications of this disease process depend on intrinsic patient factors such as age, genetics, epigenetics, voiding habits, anatomic anomalies, and extrinsic factors such as the pathogenicity of infectious agents. Knowledge about its natural history, the implications of conservative and surgical management, and their associated outcomes have evolved dramatically over time. This study aimed to use bibliometric analyses to summarize the evolution of VUR management over time. In order to accomplish this, the most referenced articles for VUR since 1950 were identified, and a comprehensive analysis of their impact on the management and understanding of VUR was performed by creating a novel impact index. METHODS: A reference search was carried out for indexed citations through the portal 'Science Citation Index' in the subsection 'Web of Science Core Collection' using 'vesicoureteral reflux' as a MeSH term. References were analyzed and subcategorized according to various subtopics. A unique impact index was developed to adjust the number of publications for the time since publication, in order to define the impact of the paper amongst the most frequently cited papers. Articles were analyzed and data were tabulated according to the number of citations, country and institute of origin, journal of publication, impact factor, and first authorship. RESULTS: Citation counts ranged from 43 to 510, and the mean number of citations per publication was 101.43. The most discussed topic was 'treatment'. The impact index showed that more recent publications have a higher impact. The author with the highest index impact had 271 citations in a period of 5 years. The top 150 articles were published across 23 countries, the majority being from the USA (Summary fig.). The most frequently cited institution had 12 publications. The journal with the highest publication referencing rate was the Journal of Urology. CONCLUSION: The most cited articles were valuable sources of information to describe the historical evolution of the pathophysiology and management of VUR. After adjusting for time since publication, the most recent publications (i.e. those published after 1990) had a higher impact index. Combining traditional bibliometric analysis with this novel impact index may allow researchers to optimize future literature analyses, while also assisting clinicians in understanding best practices for patient management based on the available literature.

[Inpatient candiduria: etiology, susceptibility to antifungal drugs and risk factors]. / Candiduria en pacientes hospitalizados: etiología, sensibilidad a los fármacos antifúngicos y factores de riesgo.

OBJECTIVE: Candida could become the second most frequent cause of nosocomial urinary tract infection. Although Candida albicans is the most important species, others have arisen as emerging pathogens. The aim of this study was to analyze the presence of candiduria in inpatients. METHODS: We performed a retrospective study of Candida isolates from adult inpatient urocultures over five years, gathering and tabulating data on: the species; susceptibility to fluconazole, amphotericin B, and voriconazole (Vitek2, BioMerieux); presence of catheter; hospital department of origin; and patient age and sex. RESULTS: We detected 289 yeast episodes, observing an annual increase: 134 (46.4%) were non-C. albicans yeasts, with 57 (19.7%) being Candida glabrata, 37 (12.8%) Candida tropicalis, 25 (8.6%) Candida parapsilosis, and 10 (3.5%) Candida lusitaniae. Most isolates derived from catheterized (240, 83.0%) and Internal Medicine Department (118, 40.8%) patients, observing an annual increase; 152 (52.6%) isolates were from males, and the mean age was >65 years. Susceptibility to antifungals was >85%. CONCLUSIONS: Inpatient urocultures should include data on the presence of Candida, which is more prevalent in Internal Medicine Department inpatients, in those with urinary catheter, and in over 65-year-olds. Almost half of the isolates were non-C. albicans yeasts, and we recommend complete identification of the species involved.

Hyperphagia and increased body weight induced by lesions of the ventral tuberomammillary system.

Individual lesions of the caudal (E1) or rostral (E2) ventral tuberomammillary nuclei induced hyperphagia in Wistar rats. The aim of the present study was to examine the additive or united effects of combined lesions of E1+E2 in food intake. E1+E2 lesions produced an immediate, potent and permanent hyperphagic response that was greater than that observed in groups with individual lesions (E1 or E2) during the 22-day observation period. Furthermore, at the end of this period (Days 17/22), the combined lesions induced a greater increase in body weight compared with groups with individual lesions. As previously reported, polydipsia is also induced by lesions of the ventral tuberomammillary subnuclei. However, in this case, responses of the individual polydipsic groups did not differ from those found in the E1+E2 ventral tuberomammillary group. These results are interpreted in terms of the hypothalamic systems involved in food and water intake.

[Assessment of adherence to antibiotic treatment in Primary Care by determining levels of the drug using a liquid chromatography technique]. / Valoración de la adherencia al tratamiento antibiótico en Atención Primaria mediante la determinación de niveles del fármaco utilizando una técnica de cromatografía líquida.

OBJECTIVE: The lack of adherence to antibiotic treatments is a matter of special interest, which has important clinical implications, as it is associated with therapeutic failure and increased bacterial resistance causing a high sani-tary cost. The objective of our study was to assess the degree of adherence to prescribed antibiotic treatment in outpatients through the detection of these in blood, urine or sputum. METHODS: Concentrations of antibiotics prescribed in 39 patients (34 with clinical suspicion of urinary tract infection and 5 with clinical suspicion of low respiratory tract infection) treated in Primary Care consultations of the Sanitary District of Almería (Spain) were determined by ultra-high performance liquid chromatography coupled to tandem mass spectrometry. RESULTS: A 48.7% of the patients did not comply correctly with the indicated treatment due to the complete or partial omission in taking the prescribed antibiotics. This lack of adherence was independent of the age and sex of the patients, the number of daily doses of the antibiotic, and whether or not they were receiving another medication. CONCLUSIONS: Precise analytical techniques such as liquid chromatography can be useful to detect inadequate or incomplete treatments as well as the degree of adherence of outpatients. Thus, adequate measures could be established that affect the control of therapeutic compliance.

[Comparative study of PTFE grafts in forearm vs cuffed permanent catheters]. / Estudio comparativo del uso de protesis vasculares de PTFE a nivel de antebrazo vs cateter permanente.

INTRODUCTION: As is universally accepted the best form of permanent vascular access for haemodialysis is the native arteriovenous fistula. A second and third options are the politetrafluoroethylene (PTFE) AV grafts and the cuffed, tunneled, internal catheters. The overall performance and complications of catheters is clearly inferior to AV fistula. There are not many studies that compare permanent catheters to grafts in terms of functionality, survival and complications. METHODS: We analyzed 81 vascular accesses carried out from october 99 to december 03 in 59 patients and during a follow-up period of 35 months. Two groups were considered. Group 1, catheters (n 42) and group 2, grafts (n 39). Clinical aspects, comorbidity index (Wright and Kanh), dialysis dose and complications and survival of the access were registered. RESULTS: Both groups were similar in age, sex, time on haemodialysis, number of previous accesses and hospitalization days. Cardiovascular morbidity and comorbidity index were significantly higher in patients with catheter. While blood flow during dialysis was higher in grafts both groups showed no significant differences in parameters of efficacy of dialysis (Kt/V, TAC BUN and PCRn). Serum albumin was lower in patients with catheter. The number of accesses that failed was higher in the graft group being thrombosis the main complication followed by infection. Kaplan-Meier curves showed better accumulated survival of permanent catheters versus grafts (61,4% vs 9,8% at 35 months). The most frequent complication of catheter was infection while in the case of grafts it was thrombosis followed by infection. CONCLUSIONS: Although they were placed in patients with higher comorbidity, cuffed, tunneled catheters showed less number of complications and better survival than PTFE grafts in our patients in haemodialysis. The main cause of failure of both vascular access was thrombosis followed by infection. The dose of dialysis obtained was no different in both groups. Cuffed, tunneled permanent catheters are a very interesting option in a number of patients in haemodialysis and they can be an option to consider in those patients with vascular difficulties and higher comorbidities.

Schwannoma de plexo braquial y toxina botulínica: a propósito de un caso / Brachial plexus schwannoma and botulinum toxin: a case report

Los schwannomas de plexo braquial son tumoraciones desarrolladas a partir de las vainas neurales de rara presentación, pero evolución benigna. Pueden ocasionar clínica, generalmente de tipo neuropático, por crecimiento local con el consiguiente efecto compresivo de estructuras neurales nobles como las raíces del plexo braquial. La toxina botulínica es una neurotoxina sintetizada por la bacteria clostridium botulinum. Su mecanismo de acción consiste en bloquear selectivamente los receptores colinérgicos de la unión neuromuscular, produciendo una parálisis neuromuscular temporal y reversible, recuperando la función en aproximadamente tres a seis meses. Presentamos el caso de un paciente diagnosticado de schwannoma de plexo braquial con efecto compresivo creciente, a quien se le plantea tratamiento con toxina botulínica en los músculos escalenos.(AU)

Brachial plexus schwannomas are tumors developed from the neural sheaths of rare presentation, but benign evolution. They can cause symptoms, generally of the neuropathic type, due to local growth with the consequent compressive effect of noble neural structures such as the roots of the brachial plexus. Botulinum toxin is a neurotoxin synthesized by the bacterium Clostridium Botulinum. Its mechanism of action consists of selectively blocking the cholinergic receptors of the neuromuscular junction, producing a temporary and reversible neuromuscular paralysis, recovering function in approximately three to six months. We present the case of a patient diagnosed with brachial plexus schwannoma with increasing compre­ssive effect who was treated with botulinum toxin in the scalene muscles.(AU)

A new case report of urinary tract infection due to KPC-3-producing klebsiella pneumoniae (ST258) in Spain. / A propósito de un nuevo caso de infección del tracto urinario por klebsiella pneumoniae (ST258) productor de KPC-3 en España.

OBJECTIVE: We describe the characterization of a new isolated in Spain of Klebsiella pneumoniae ST258 producing KPC-3, carbapenems non-susceptible, recovered from a sample of urine from a patient with urinary tract infection and no history of carbapenems exposure. METHODS: After the isolation, identification of K. pneumoniae was performed by biochemical tests and mass spectrometry. The carbapenems susceptibility testing was performed by microdilution and E-test in cation-adjusted Mueller-Hinton. The study was completed by Rapidec® Carba NP. In order to determine the genetic basis of resistance to carbapenems we used Xpert® Carba-R for carbapenemase type and subtype was subsequently analyzed by amplification by PCR and sequencing. RESULT: We demonstrated by MLST that the strain belonged to the clone of high-risk ST258. CONCLUSIONS: This is the first characterization, in our media, of a clinical isolated of K. pneumoniae ST258 producing KPC-3 and no history of carbapenems exposure.

[Multilocus Sequence Typing analysis of human Campylobacter coli in Granada (Spain)].

OBJECTIVE: Different subtypes of Campylobacter spp. have been associated with diarrhoea and a Multilocus Sequence Typing (MLST) method has been performed for subtyping. In the present work, MLST was used to analyse the genetic diversity of eight strains of Campylobacter coli. METHODS: Nineteen genetic markers were amplified for MLST analysis: AnsB, DmsA, ggt, Cj1585c, CJJ81176-1367/1371, Tlp7, cj1321-cj1326, fucP, cj0178, cj0755/cfrA, ceuE, pldA, cstII, cstIII. After comparing the obtained sequences with the Campylobacter MLST database, the allele numbers, sequence types (STs) and clonal complexes (CCs) were assigned. RESULTS: The 8 C. coli isolates yielded 4 different STs belonging to 2 CCs. Seven isolates belong to ST-828 clonal complex and only one isolate belong to ST-21. Two samples came from the same patient, but were isolated in two different periods of time. CONCLUSIONS: MLST can be useful for taxonomic characterization of C. coli isolates.

Glutathione, glutathione S-transferase and reactive oxygen species of human scalp sebaceous glands in male pattern baldness.

We investigated the contribution of reactive oxygen species to the development of sebaceous gland hyperplasia and the characteristics of the glutathione S-transferase/glutathione system in male pattern baldness. Glutathione S-transferase, glutathione, and thiobarbituric acid-reactive substances were determined in sebaceous gland-enriched scalp skin of men affected by male pattern baldness and were subjected to hair autotransplantation. In comparison with the hairy occipital-donor areas, the following results were obtained in alopecic frontoparietal samples: glutathione S-transferase-specific activity increased 7-fold (p < 0.001); enzyme affinity towards 1-chloro-2,4-dinitrobenzene decreased 2-fold (p = 0.009); glutathione content decreased 2.5-fold (p = 0.017); and thiobarbituric acid reactive substances increased 2-fold (p = 0.006). Chromatofocusing analysis, bromosulfophthalein IC50 values, enzyme-linked immunosorbent assay, and immunohistochemistry with polyclonal antibodies raised against glutathione S-transferases alpha, mu, and pi demonstrated the presence of alpha, pi, and probably the 5.8 alpha isoenzymes in the sebaceous gland. These results support the hypothesis that reactive oxygen species are involved in the pathogenesis of sebaceous gland hyperplasia in male pattern baldness.

Modifications of glutathione S-transferase (GST) activity in the last period of pregnancy in rats treated with benzo(a)pyrene (BP).

Pregnant rats were treated with benzo(a)pyrene (BP) (50 mg/kg every 2 days) from day 7 of pregnancy and killed at day 16 or day 19. Km of erythrocyte glutathione S-transferase (GST) decreased during pregnancy in control rats (1.29 x 10(-3) M at day 16; 1.02 x 10(-3) M at day 19) and even more in treated rats at day 19 (0.71 x 10(-3) M). Vmax was lower in treated rats at day 19 (0.56 mumol/min/g haemoglobin) than in control rats (0.88 mumol/min/g haemoglobin) suggesting inhibition of the enzyme. Placental weight diminished in treated rats at day 19 but was not affected at day 16. Chromatofocusing of placental GST showed a single peak (pH 8.3-8.6) in control and treated rats on day 16 and an additional peak (pH 7.0-7.4) in treated rats on day 19. An increase in Km (2.84 x 10(-3) M) and Vmax (69 nmol/min/mg protein) in placental GST was observed in treated rats at day 16 (Km = 1.61 x 10(-3) M; Vmax = 43.3 nmol/min/mg protein, in control rats) followed by a decrease in these parameters in rats treated until day 19 (Km = 1.63 x 10(-3) M; Vmax = 48.7 nmol/min/mg protein). These results suggest that BP, initially, stimulates GST synthesis in placenta, followed by an inhibition of the enzyme at day 19. Fetal weight was also affected by BP treatment, especially at day 16. Km and Vmax values of fetal GST were higher in treated rats at day 16 than in control rats but these differences were not detectable at day 19. This may be explained by the more protective role of the placenta at day 19 than at day 16. Glutathione content in erythrocytes, placenta and fetus was not affected by BP.

Refractory periods of neurons mediating stimulation-elicited eating and brain stimulation reward: interval scale measurement and tests of a model of neural integration.

Paired-pulse stimulation methods have been used in many studies to measure the excitability properties of the directly stimulated neurons mediating stimulation-elicited behaviors. In this article those methods are evaluated quantitatively. The most frequently used method, in which rate of behavior is measured as a function of conditioning-test (C-T) interval, is shown to be inadequate since the results obtained depend on the frequency of stimulation. In order to account for this dependence, a physical model of brain stimulation which implies that the effects of frequency and C-T interval should be multiplicative is proposed. In separate experiments, conjoint and functional measurement methods were used to test this model and to measure the refractory periods of neurons mediating stimulation-elicited eating and brain stimulation reward. The results of both experiments strongly supported the multiplicative model for C-T intervals in the refractory period range (.4-2.0 msec) and indicated that the frequency threshold method (Yeomans, 1975, and the present Experiment 2) provides interval scale measurement of refractory period effects. The refractory period curves obtained for neurons mediating stimulation-elicited eating and brain stimulation reward were very similar, rising steeply at C-T intervals from .4 to 1.2 msec and more gradually at intervals from 1.2 msec to 2.0 msec. These curves were also similar to one previously obtained for bar-pressing self-stimulation (Yeomans, 1975). The implications of these similarities are discussed.

A study of the response to several dipsogenic treatments in rats with mammillary polydipsia and with centrally induced diabetes insipidus.

Several brain areas have been implicated in the regulation of water intake and body fluid homeostasis. Electrolytic lesions located in the mammillary area have proved to induce a strong polydipsia. The cause of this overconsumption is not understood, although other studies have indicated a possible relationship with the mechanisms involved in sodium control. In this paper, we consider whether mammillary polydipsia is related to diabetes insipidus. In this regard, animals with mammillary lesions were submitted to several dipsogenic treatments, both osmotic and volemic. These subjects showed a differential response to hypertonic NaCl compared with controls. No effect could be seen in relation to the other treatments employed, that is, sucrose and polyethylene glycol. On the other hand, this differential response to NaCl was not observed in those animals with diabetes insipidus centrally induced by means of lesions in the median eminence. Thus, mammillary polydipsia and diabetes insipidus-related water intake seem to be different phenomena. The possible relationship between mammillary polydipsia and sodium control is discussed.