The use of treatment wetlands plants for protein and cellulose valorization in biorefinery platform.

Different wetland plants were evaluated regarding their potential to be used in further green biorefining platforms to produce soluble protein and cellulose-textile fibers. The results show a higher protein content in the plants grown in treatment wetland conditions, compared with the same species grown in natural conditions, and diverse effect on the content of cellulose, hemicellulose, and lignin, depending on the plant species, more than the growing environment. The TW biomass did not represent a risk regarding accumulation of heavy metals, named Pb, Cd, and Cr, since the studied plants did not present it in their tissues, neither in the roots nor in the leaves. The results regarding cellulose quality of the TW plants showed positive results, having values of molar mass distributions and degrees of polymerization that suggest a suitability to be considered for cellulose-fiber textiles studies. This is one of the first approaches, in the TW field, to establish a new criterion for selecting plant species to be planted in the system, aiming at recovering resources and use them as inputs for biorefineries and sustainable biobased products.

Immune surveillance for six vaccinable pathogens using paired plasma and dried blood spots in HIV infected and uninfected children in Kinshasa.

Child vaccination reduces infant mortality rates. HIV-infected children present higher risk of diseases than non-infected. We report the protection coverage rates for 6 vaccine-preventable diseases in a paediatric population from the Democratic Republic of the Congo (DRC) and the impact of HIV infection, providing the first data on the validity of dried blood samples (DBS) to monitor the immune protection. During 2016-2018 DBS from 143 children/adolescents were collected in Kinshasa (DRC), being 52 HIV-infected. Forty-two had a paired plasma sample. Protective IgG was quantified (VirClia-IgG,VIRCELL) to obtain the optimal cut-off in IgG detection in DBS. ROC curves were generated with R software and statistical analyses with Stata. Protective IgG levels varied across pathogens, not reaching herd immunity. HIV-infected presented lower vaccine protection than uninfected for all analyzed pathogens, except rubella, with statistically significant differences for measles (30.8% vs. 53.8%; p = 0.008) and tetanus (3.8% vs. 22%; p = 0.0034). New cut-offs were calculated when using DBS to improve test performance. We reinforce the necessity to increase pediatric vaccination coverage in Kinshasa, especially in HIV seropositive, with less capacity to maintain adequate antibody levels. DBS were useful to monitor vaccination coverage in seroprevalence studies in resource-limited settings, after optimizing the cut-off value for each pathogen.

Spread of a new Chlamydia trachomatis variant from men who have sex with men to the heterosexual population after replacement and recombination in ompA and pmpH genes.

OBJECTIVES: Sexually transmitted infections are frequently related to outbreaks in high-risk populations due to the dense sexual networks. We wanted to determine the dissemination of a Chlamydia trachomatis variant characterized by the pmpH-recombinant gene between L and G genotypes, which was previously described in a high-risk population. METHODS: A total of 449 samples were analysed in two periods ranging from 2009 to 2015 for detection of the pmpH-recombinant gene. For those samples yielding positive amplification, a sampling was selected for phylogenetic reconstructions based on sequencing of five chromosomal genes. RESULTS: Globally this variant was found in 113 of the 449 samples (25%). During the first years (2009-13), this variant was found almost exclusively in rectal samples (30/112 samples) of men who have sex with men and in only one non-rectal sample (1/63). In 2014, this variant was also found in urethral and pharyngeal samples (1/24 and 1/7, respectively). However, in 2015, an epidemiological change was observed as the proportion of this variant had increased in rectal samples (20/51; 39%) and non-rectal samples, including cervical samples (51/142; 36.4%). The molecular characterization revealed the replacement of the ompA gene belonging to subtype G in samples recovered from 2009 to 2013 by the ompA gene belonging to subtype J after 2013. CONCLUSIONS: Our data would support the evidence that subtype J could be a 'subtype bridge' between different sexual networks, as subtype J has been found in men who have sex with men and heterosexual populations in similar proportions. This work reveals the necessity of implementing molecular surveillance in extra-rectal samples to help us understand the gaps in transmission.

The rise of ampicillin-resistant Enterococcus faecium high-risk clones as a frequent intestinal colonizer in oncohaematological neutropenic patients on levofloxacin prophylaxis: a risk for bacteraemia?

Levofloxacin extended prophylaxis (LEP), recommended in oncohaematological neutropenic patients to reduce infections, might select resistant bacteria in the intestine acting as a source of endogenous infection. In a prospective observational study we evaluated intestinal emergence and persistence of ampicillin-resistant Enterococcus faecium (AREfm), a marker of hospital adapted high-risk clones. AREfm was recovered from the faeces of 52 patients with prolonged neutropenia after chemotherapy, at admission (Basal), during LEP, and twice weekly until discharge (Pos-LEP). Antibiotic susceptibility, virulence traits and population structure (pulsed-field gel electrophoresis and multilocus sequence typing) were determined and compared with bacteraemic isolates. Gut enterococcal population was monitored using a quantitative PCR quantification approach. AREfm colonized 61.4% of patients (194/482 faecal samples). Sequential AREfm acquisition (25% Basal, 36.5% LEP, 50% Pos-LEP) and high persistent colonization rates (76.9-89.5%) associated with a decrease in clonal diversity were demonstrated. Isolates were clustered into 24 PFGE-patterns within 13 sequence types, 95.8% of them belonging to hospital-associated Bayesian analysis of population structure subgroups 2.1a and 3.3a. Levofloxacin resistance and high-level streptomycin resistance were a common trait of these high-risk clones. AREfm-ST117, the most persistent clone, was dominant (60.0% isolates, 32.6% patients). It presented esp gene and caused 18.2% of all bacteraemia episodes in 21% of patients previously colonized by this clone. In AREfm-colonized patients, intestinal enrichment in the E. faecium population with a decline in total bacterial load was observed. AREfm intestinal colonization increases during hospital stay and coincides with enterococci population enrichment in the gut. Dominance and intestinal persistence of the ST117 clone might increase the risk of bacteraemia.

Morphology, cytochemical staining, and ultrastructural characteristics of the blood cells of the giant lizard of El Hierro (Gallotia simonyi).

The object of this study was to examine the erythrocytes, leukocytes and thrombocytes of the giant lizard of El Hierro (Gallotia simonyi) by light and electron (TEM) microscopy, and cytochemical staining. Smears were prepared from blood from the ventral coccygeal vein of 10 healthy adult lizards (five males and five females) from the Giant Lizard of El Hierro Reproduction and Research Centre, Canary Islands, Spain. The cytochemical stains used were: benzidine peroxidase (BP), chloroacetate esterase (CAE), alpha-naphthyl acetate esterase (ANAE), acid phosphatase (AP), periodic acid-Schiff (PAS), toluidine blue (TB) and May-Grünwald-Giemsa (MGG). Electron microscopy was also performed on all samples. Heterophils had granules that were heterogeneous in both size and electron density, and stained with BP, PAS and ANAE. Eosinophil granules were homogeneously electron-dense and stained for AP, CAE and ANAE. Basophils had both highly and moderately electron-dense granules, and stained with TB and ANAE. Azurophil granules were of low electron-density and stained for AP, CAE and ANAE. Azurophil cytoplasm was vacuolated on TEM. The cytoplasm of lymphocytes contained many ribosomes and was positive for AP. Monocytes had a large nucleus and a vacuolated cytoplasm but did not stain by any of the cytochemical methods used. Thrombocytes had a relatively large nucleus but little cytoplasm; they did not stain cytochemically. The blood cells of the giant lizards of El Hierro differ from those of other members of the Order Squamata both morphologically and cytochemically. The variation in cytochemical responses in the blood of reptiles makes it necessary to study species individually if meaningful clinical decisions are to be made.

Comparative haematology and blood chemistry of endangered lizards (Gallotia species) in the Canary Islands.

Blood samples were taken from the ventral coccygeal vein of 15 El Hierro giant lizards (Gallotia simonyi) (seven females and eight males), six La Gomera giant lizards (Gallotia bravoana) (four males and two females) and four Tenerife giant lizards (Gallotia intermedia) (two males and two females), and 31 blood parameters were measured. Among the haematological parameters there were significant differences between the three species in heterophils, azurophils and lymphocytes, but no significant differences in red blood cell count, white blood cell count, haemoglobin, packed-cell volume, monocytes, eosinophils and basophils. In terms of blood chemistry there were significant differences between the three species in cholesterol, triglycerides, glucose, sodium, chloride, urea, uric acid, total proteins, prealbumin, albumin and gamma globulins, but no significant differences in calcium, potassium, aspartate aminotransferase, alanine aminotransferase, creatine kinase, bile acids, alpha-1 and alpha-2 globulins and beta globulins.

Clinical and epidemiological characterization of a lymphogranuloma venereum outbreak in Madrid, Spain: co-circulation of two variants.

The lymphogranuloma venereum (LGV) outbreak described in the Netherlands in 2003, increased the interest in the genotyping of Chlamydia trachomatis. Although international surveillance programmes were implemented, these studies slowly decreased in the following years. Now data have revealed a new accumulation of LGV cases in those European countries with extended surveillance programmes. Between March 2009 and November 2011, a study was carried out to detect LGV cases in Madrid. The study was based on screening of C. trachomatis using commercial kits, followed by real-time pmpH-PCR discriminating LGV strains, and finally ompA gene was sequenced for phylogenetic reconstruction. Ninety-four LGV infections were identified. The number of cases increased from 10 to 30 and then to 54 during 2009-2011. Incidence of LGV was strongly associated with men who have sex with men; but in 2011, LGV cases were described in women and heterosexual men. Sixty-nine patients were also human immunodeficiency virus (HIV) positive, with detectable viral loads at the moment of LGV diagnosis, suggesting a high-risk of co-transmission. In fact, in four patients the diagnosis of HIV was simultaneous with LGV infection. The conventional treatment with doxycycline was prescribed in 75 patients, although in three patients the treatment failed. The sequencing of the ompA gene permitted identification of two independent transmission nodes. One constituted by 25 sequences identical to the L2b variant, and a second node including 37 sequences identical to L2. This epidemiological situation characterized by the co-circulation of two LGV variants has not been previously described, reinforcing the need for screening and genotyping of LGV strains.

[Complications related with cocaine abuse that required hospital admission]. / Complicaciones relacionadas con el consumo de cocaína que precisaron ingreso hospitalario.

INTRODUCTION: Although cocaine abuse is an increasingly important medical problem, many manifestations of its toxicity are not well understood. The aim of this study is to review the most serious clinical manifestations related to cocaine abuse. PATIENTS AND METHOD: We reviewed the medical records of all patients over 16 years of age admitted to the hospital from January 1994 to December 2005 where cocaine abuse was recorded in their clinical history. RESULTS: A total of 170 patients, with 188 episodes and 268 pathologic manifestations related to cocaine abuse were included. Thirty two out of the 170 patients (18.8%) were females. Mean age was 33 +/- 11 years, with no significant difference between males and females. A total of 88.8% were smokers, 70% had alcohol abuse and 67.3% had other illegal drug abuses. The more frequent reason for their hospitalization was: pulmonary infection (29.6%), bronchial hyperreactivity (14%), acute psychotic attack related to drugs (12%), ischemic heart disease (10%), infectious endocarditis (7.8%), cerebrovascular disease (8.6%), seizures (6.2%) and severe abdominal complications (2.3%). Eight patients died (6.25%). The association with cocaine was only suspected in 46% of the toxic manifestations. CONCLUSIONS: Several clinical manifestations are associated to cocaine abuse and its consumption causes potentially fatal complications. The integral treatment of these patients could be improved if these complications are kept in mind.

[Incidence and prevalence of hip fractures in the province of Cáceres and their evolutionary trend]. / Incidencia y prevalencia de las fracturas de cadera en la provincia de Cáceres y su tendencia evolutiva.

OBJECTIVE: There are great variations in the yearly incidence and the evolution of hip fractures secondary to bone fragility and associated to minimum trauma in patients older than 50. Because of the lack of data about these fractures in the province of Cáceres, we carried out a study to know their incidence and prevalence, and their evolutionary trend. MATERIAL AND METHODS: One thousand five hundred seventy seven hip fractures in the years 1997 through 2000 (both included) are studied. The type of fracture is obtained through 820.00 to 829.00 corresponding codes. RESULTS: One thousand one hundred ninety nine occur in women and 378 in men, being the average presentation age 81 +/- 9 years and 74 +/- 18 years, respectively; both data were significantly lower in men (p < 0.0001). The incidence index by sex is 2.6 women/men/100,000 inhabitants/year. The percentage of fractures by sex do not vary, depending on the anatomical location. The higher number of fractures in both sexes is in the trochanter (p < 0.0001); in men is higher in the year 2000 than in 1997 (p < 0.0001); in women their incidence and prevalence is also higher in the year 2000 than in the previous years (p < 0.0001). In conclusion we can point out that the incidence of the hip fractures secondary to low-energy trauma in the province of Cáceres population is increasing in the last few years, and that this incidence is higher in women than men, although the percentage of the fracture type according to its anatomical location is the same in women and men.

Complicaciones relacionadas con el consumo de cocaína que precisaron ingreso hospitalario / Complications related with cocaine abuse that required hospital admission

Introducción. Aunque la cocaína supone un problema sanitario de importancia creciente, muchos síntomas de su toxicidad no son bien conocidos. El objetivo de este estudio es dar una visión global de las manifestaciones clínicas más graves relacionadas con la cocaína. Pacientes y método. Se revisaron los historiales clínicos de todos los pacientes mayores de 16 años de edad ingresados en nuestro hospital desde el 1 de enero de 1994 hasta el 31 de diciembre de 2005, entre cuyos códigos diagnósticos al alta figuraba el consumo de cocaína. Resultados. Se incluyeron 170 pacientes que sumaron un total de 188 episodios y 268 manifestaciones patológicas relacionadas con la cocaína. De los 170 pacientes, 32 (18,8%) eran mujeres. La edad media fue de 33 ± 11 años y no difirió significativamente entre hombres y mujeres. El 88,8% era fumador, el 70% ingería alcohol en exceso y el 67,3% consumía otras drogas ilegales. El motivo de ingreso más frecuente fue: infección pulmonar (29,6%), hiperreactividad bronquial grave (14%), trastorno psicótico agudo (12%), cardiopatía isquémica (10%), enfermedad cerebrovascular (8,6%), endocarditis bacteriana (7,8%), convulsiones (6,2%) y complicaciones abdominales graves (2,3%). Ocho pacientes fallecieron (6,25%). La asociación con la cocaína sólo se sospechó en un 46% de las manifestaciones clínicas. Conclusiones. El espectro de manifestaciones clínicas asociadas al consumo de cocaína es amplio y causa complicaciones potencialmente fatales. Mejorar su conocimiento por parte de los clínicos puede facilitar el tratamiento integral de estos enfermos (AU)

Introduction. Although cocaine abuse is an increasingly important medical problem, many manifestations of its toxicity are not well understood. The aim of this study is to review the most serious clinical manifestations related to cocaine abuse. Patients and method. We reviewed the medical records of all patients over 16 years of age admitted to the hospital from January 1994 to December 2005 where cocaine abuse was recorded in their clinical history. Results. A total of 170 patients, with 188 episodes and 268 pathologic manifestations related to cocaine abuse were included. Thirty two out of the 170 patients (18.8%) were females. Mean age was 33 ± 11 years, with no significant difference between males and females. A total of 88.8% were smokers, 70% had alcohol abuse and 67.3% had other illegal drug abuses. The more frequent reason for their hospitalization was: pulmonary infection (29.6%), bronchial hyperreactivity (14%), acute psychotic attack related to drugs (12%), ischemic heart disease (10%), infectious endocarditis (7.8%), cerebrovascular disease (8.6%), seizures (6.2%) and severe abdominal complications (2.3%). Eight patients died (6.25%). The association with cocaine was only suspected in 46% of the toxic manifestations. Conclusions. Several clinical manifestations are associated to cocaine abuse and its consumption causes potentially fatal complications. The integral treatment of these patients could be improved if these complications are kept in mind (AU)

Fístula humerohumeral como técnica de recurso en pacientes sin patrimonio venoso superficial / Brachiobrachial fistula as a last-resort technique in patients with no surface venous pool

Introducción. El constante incremento de la población renal crónica junto con su mayor supervivencia nosobliga a optimizar el patrimonio venoso para la realización de accesos vasculares autólogos, pues éstos presentan unamenor tasa de complicaciones y una mayor permeabilidad que los protésicos. Casos clínicos. Presentamos dos pacientescon insuficiencia renal crónica terminal en hemodiálisis, con múltiples antecedentes de fístulas arteriovenosas (FAV) antólogas,todas ellas trombosadas, que no presentaban un patrimonio venoso superficial válido para realizar nuevos accesosautológos. A ambos se les realizó una FAV humerohumeral con superficialización venosa y mostraron una buenapermeabilidad del acceso, lo que fue útil para poder proseguir con sus sesiones de diálisis periódicas, de manera que sepudo demorar la realización de un acceso vascular protésico. No hubo ninguna complicación relacionada con la técnicaquirúrgica ni para la canulación de ésta. Conclusión. A través de estos dos casos describimos esta técnica quirúrgica yla planteamos como una posible alternativa en aquellos pacientes que no presentan un patrimonio venoso superficial apto.En un futuro esta técnica puede llegar a formar parte del algoritmo de manejo de los pacientes con insuficiencia renalcrónica terminal que precisan la realización de un acceso vascular

Introduction. The steady increase in the population suffering from chronic renal failure together with longersurvival times means that it is necessary to optimise the venous pool for performing autologous vascular accesses, sincethese offer a lower rate of complications and greater patency than prosthetic accesses. Case reports. We report the casesof two patients with terminal chronic renal failure on haemodialysis who did not present a valid superficial venous poolfor performing new autologous accesses; both patients had a history of numerous antologous arteriovenous fistulas(AVF), all of which had thrombosed. Brachiobrachial AVF with venous superficialisation was performed and patency ofthe access was seen to be good in both cases. This was useful in enabling them to continue with their periodical dialysissessions and made it possible to delay having to create a prosthetic vascular access. There were no complicationsrelated to the surgical technique or to the cannulation that was carried out. Conclusions. This surgical procedure isdescribed through these two cases and we suggest it as a possible alternative in patients who do not have a suitablesuperficial venous pool. In the future this technique may become part of the management algorithm for patients withterminal chronic renal failure in whom it is necessary to carry out a vascular access