0000000000205047
AUTHOR
Rosa Oltra
Factores relacionados con el riesgo de trombosis en pacientes con lupus y positividad para anticuerpos antifosfolipídicos
Fundamento y objetivo Los anticuerpos antifosfolipidicos (AAF) aparecen con frecuencia asociados al lupus eritematoso sistemico (LES), con lo que aumenta el riesgo de trombosis. El objetivo del presente trabajo ha sido analizar el perfil temporal y los factores de riesgo de accidentes tromboticos en pacientes con LES. Pacientes y metodo Se ha realizado un estudio retrospectivo en 102 pacientes con LES controlados en nuestra unidad –edad media de 37,5 anos (extremos, 8-85); 90 mujeres–, con una mediana de seguimiento de 72 meses (extremos, 9-324). Del total de la muestra, 41 (40,2%) presentaban AAF positivos. La probabilidad de presentar un accidente trombotico durante el seguimiento se calc…
Performance of a Highly Sensitive Mycobacterium tuberculosis Complex Real-Time PCR Assay for Diagnosis of Pulmonary Tuberculosis in a Low-Prevalence Setting: a Prospective Intervention Study
ABSTRACT The potential impact of routine real-time PCR testing of respiratory specimens from patients with presumptive tuberculosis in terms of diagnostic accuracy and time to tuberculosis treatment inception in low-prevalence settings remains largely unexplored. We conducted a prospective intervention cohort study. Respiratory specimens from 1,020 patients were examined by acid-fast bacillus smear microscopy, tested by a real-time Mycobacterium tuberculosis complex PCR assay (Abbott RealTi me MTB PCR), and cultured in mycobacterial media. Seventeen patients tested positive by PCR (5 were acid-fast bacillus smear positive and 12 acid-fast bacillus smear negative), and Mycobacterium tubercul…
Clostridium difficile heterogeneously impacts intestinal community architecture but drives stable metabolome responses
Clostridium difficile-associated diarrhoea (CDAD) is caused by C. difficile toxins A and B and represents a serious emerging health problem. Yet, its progression and functional consequences are unclear. We hypothesised that C. difficile can drive major measurable metabolic changes in the gut microbiota and that a relationship with the production or absence of toxins may be established. We tested this hypothesis by performing metabolic profiling on the gut microbiota of patients with C. difficile that produced (n=6) or did not produce (n=4) toxins and on non-colonised control patients (n=6), all of whom were experiencing diarrhoea. We report a statistically significant separation (P-value o0…
Antihypertensive activity of angiotensin II AT1 receptor antagonists: a systematic review of studies with 24 h ambulatory blood pressure monitoring.
To perform a systematic review of the antihypertensive activity of the angiotensin II AT1 receptor antagonists (ARB).Studies in which blood pressure (BP) was measured using ambulatory BP monitoring for at least 24 h were collected from MEDLINE. Data for each treatment group, ARB, placebo or the drug used for its comparison were obtained from the selected studies. Only studies with a minimum of quality criteria were selected. The final study group contained 36 publications, with a total of 47 patient cohorts receiving ARB in monotherapy, 10 with placebo, 10 with amlodipine, and five with enalapril. The reduction in clinical and ambulatory BP during 24 h, day, night and the last 4-h period fo…
Early adjustment of empirical antibiotic therapy of bloodstream infections on the basis of direct identification of bacteria by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and Gram staining results
Abstract Introduction To assess the potential added value of rapid MALDI-TOF MS-based identification of bacteria in positive blood cultures to the information provided by Gram staining for adequate empirical antibiotic treatment adjustments in patients with bloodstream infections (BSI). Methods We conducted a retrospective, single-center, pre-post quasi-experimental study. In the pre-MALDI-TOF MS phase of the study antibiotic adjustments were made on the basis of Gram stain results, whereas in the MALDI-TOF MS phase they were based on information provided by Gram staining and MALDI-TOF MS results. No antimicrobial stewardship program for BSI was in place within the study period. Antibiotic …
High vancomycin MICs within the susceptible range in Staphylococcus aureus bacteraemia isolates are associated with increased cell wall thickness and reduced intracellular killing by human phagocytes
Vancomycin minimum inhibitory concentrations (MICs) at the upper end of the susceptible range for Staphylococcus aureus have been associated with poor clinical outcomes of bloodstream infections. We tested the hypothesis that high vancomycin MICs in S. aureus bacteraemia isolates are associated with increased cell wall thickness and suboptimal bacterial internalisation or lysis by human phagocytes. In total, 95 isolates were evaluated. Original vancomycin MICs were determined by Etest. The susceptibility of S. aureus isolates to killing by phagocytes was assessed in a human whole blood assay. Internalisation of bacterial cells by phagocytes was investigated by flow cytometry. Cell wall thic…