RESUMEN
Botulism is a severe neuroparalytic disorder that can be potentially life-threatening. In Barcelona, Spain, no outbreaks had been reported in the past 25 years. However, in September 2011, two outbreaks occurred involving two different families. A rare case of Clostridium baratii which produced a neurotoxin F outbreak was detected in five family members who had shared lunch, and several days before that another family was affected by C. botulinum toxin A which was probably present in homemade pâté.
Asunto(s)
Botulismo/epidemiología , Clostridium/clasificación , Clostridium/aislamiento & purificación , Brotes de Enfermedades , Toxinas Botulínicas/análisis , Salud de la Familia , Femenino , Humanos , Masculino , España/epidemiologíaRESUMEN
Between 1 September 2008 and 9 March 2009, 150 cases of hepatitis A were reported in Barcelona representing a threefold increase compared with the same period in previous two years. The majority of the cases occurred in adult men, including 87 who reported having sex with men. This indicated the possibility of an outbreak ongoing in the population of men who have sex with men (MSM) and emphasised the need to target this community with more effective vaccination programmes.
Asunto(s)
Brotes de Enfermedades , Hepatitis A/epidemiología , Homosexualidad Masculina , Conducta Sexual , Sexo Inseguro , Adulto , Brotes de Enfermedades/prevención & control , Hepatitis A/etiología , Hepatitis A/prevención & control , Humanos , Masculino , España/epidemiología , Sexo Inseguro/prevención & controlRESUMEN
Groundwater, the hidden part of the hydrological cycle, is often overlooked in the freshwater discourse, partly because the damage and changes that human activities cause are not immediately visible. Increasingly across the world, groundwater resources are strained with serious consequences.
Asunto(s)
Conservación de los Recursos Naturales , Suelo , Abastecimiento de Agua , Agua DulceRESUMEN
SETTING: Nine public health care centres in four Spanish cities. OBJECTIVE: To evaluate the efficacy and safety of 2 months of rifampicin (R) plus pyrazinamide (Z) therapy (2RZ) compared with a 6-month course of isoniazid therapy (6H) for treating latent tuberculosis infection (LTBI). DESIGN: Multicentered, randomised, comparative and prospective trial conducted in HIV-seronegative contacts of infectious pulmonary TB cases. RESULTS: Of 352 individuals, 199 received 6H and 153 2RZ; 73% of contacts receiving 6H and 71% receiving 2RZ completed treatment (P = 0.73). Treatment interruption due to hepatotoxicity (ALT/AST > 5 times upper limit of normal) was observed in 10% of contacts in the 2RZ group and in 2.5% of the 6H group (P = 0.007). This higher than expected rate of hepatotoxicity in the 2RZ arm led to premature termination of the study. Severe or fatal liver injury was not detected. Liver function tests normalised after discontinuation of treatment. We conclude that the use of RZ should only be considered when other regimens are unsuitable and intensive monitoring of liver function is feasible.
Asunto(s)
Antibióticos Antituberculosos/uso terapéutico , Seronegatividad para VIH , Pirazinamida/uso terapéutico , Rifampin/uso terapéutico , Tuberculosis Pulmonar/tratamiento farmacológico , Adolescente , Adulto , Antibióticos Antituberculosos/administración & dosificación , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , VIH/inmunología , Anticuerpos Anti-VIH/inmunología , Humanos , Lactante , Masculino , Estudios Prospectivos , Pirazinamida/administración & dosificación , Rifampin/administración & dosificación , España , Resultado del Tratamiento , Prueba de Tuberculina , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/diagnósticoRESUMEN
Water shold be costed so that it is valued, and fees should be transparent and contribute to adequate cost recovery with consideration of social, economic and environmental effects. There is a need for targeted subsidies to assist the poor. Water pollution fees for point sources can reduce discharges.
Asunto(s)
Impuestos , Contaminación del Agua/economía , Abastecimiento de Agua/economía , Costos y Análisis de Costo , Ambiente , Humanos , Condiciones SocialesRESUMEN
UNLABELLED: This research comprised a pilot open prospective clinical study comparing T-cell subset reconstitution in antiretroviral-naive patients, after 12 months of HAART when treatment was initiated in early stages (ES; n = 18) of infection versus advanced stages (AS; n = 20). CONTROL GROUP: 10 healthy HIV-negative individuals. Immunophenotypic markers were evaluated before and after 6-and 12-months' therapy. Functional assays were performed in one subset. RESULTS: Viral load (VL) was < 200 copies/ml in all patients. Median percentages of CD4+ pretherapy were 33% and 6%, respectively, in the ES and AS groups, increment after 12 months of therapy was +15% and +13% respectively. Only the ES group achieved normal values. Declines of CD8+ percentage were significantly higher in the ES (-18%) than in the AS group (-2%). CD4+ memory and naive cells in the ES group were similar to those of controls before treatment and did not change after therapy. In contrast, CD4+ memory and naive cells in the AS group did not reach normal levels despite treatment. In the ES group, there was a significant increment in CD8+ naive cells (+8%) and a decrement in CD8+CD38+ cells (-17%), both populations reached values close to normal, whereas these subsets remained far from normal in the AS group. Improvement of lymphoproliferative response after therapy was observed in both groups. One patient in the ES group showed positive LPR against p24 after treatment. After 12 months' highly active antiretroviral therapy, only those who began such therapy in ES disease reached values within the range of healthy controls. To achieve a more complete immunologic reconstitution, early initiation of potent antiretroviral therapy should be recommended.
Asunto(s)
Terapia Antirretroviral Altamente Activa , Infecciones por VIH/tratamiento farmacológico , VIH-1/inmunología , Subgrupos de Linfocitos T , Adulto , Anciano , Anticuerpos Monoclonales , Femenino , Citometría de Flujo , Infecciones por VIH/sangre , Inhibidores de la Proteasa del VIH/inmunología , Inhibidores de la Proteasa del VIH/uso terapéutico , VIH-1/efectos de los fármacos , Humanos , Indinavir/inmunología , Indinavir/uso terapéutico , Lamivudine/inmunología , Lamivudine/uso terapéutico , Activación de Linfocitos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , ARN Viral/sangre , Inhibidores de la Transcriptasa Inversa/inmunología , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Ritonavir/inmunología , Ritonavir/uso terapéutico , Conteo por Cintilación , Estadísticas no Paramétricas , Estavudina/inmunología , Estavudina/uso terapéutico , Tritio , Carga ViralRESUMEN
No disponible
Asunto(s)
Masculino , Humanos , Infecciones Oportunistas Relacionadas con el SIDA , Neumonía por Pneumocystis , España , Trombocitopenia , Factor Estimulante de Colonias de Granulocitos y Macrófagos , Áreas de Influencia de SaludRESUMEN
No disponible
Asunto(s)
Anciano , Masculino , Humanos , Distrofia Simpática Refleja , Enfermedades Autoinmunes , Enfermedad Crónica , Cirrosis Hepática BiliarRESUMEN
OBJECTIVES: To assess whether an almost complete restoration of immune system can be achieved when antiretroviral therapy is initiated at very early stages of asymptomatic chronic HIV-1 infection. DESIGN: T cell subsets and cell-mediated responses were analysed at baseline and after 12 months of either a double or a triple antiretroviral therapy in 26 asymptomatic HIV-1-infected patients with CD4 T cell counts > 500 x 10(6) cells/l and a baseline plasma viral load > 10000 copies/ml. RESULTS: Triple therapy was significantly more effective in reducing plasma HIV RNA to undetectable levels, in returning CD4:CD8 ratio to nearly normal levels, in reducing activated cells (CD38) and in increasing naive (CD45RA+CD45RO-) and memory (CD45RA-CD45RO+) CD4 cells. Both double and triple therapies caused a clear decrease in memory (CD45RA-CD45RO+) CD8 cells as well as a significant increase in the CD28 subset of CD8 cells. At baseline, there was an important increase in cells producing interferon-gamma (IFNgamma) with no significant abnormalities in T lymphocytes producing interleukin 2 (IL-2), tumour necrosis factor alpha and interleukin 4. Both types of therapy reduced IFNgamma- and IL2-producing CD4 T lymphocytes while IFNgamma-producing CD8 cells remained increased. Even before therapy, these HIV-1-positive patients lacked significant abnormalities in the T cell responsiveness to polyclonal stimuli as well as in the secretion of CCR5 chemokines by peripheral blood mononuclear cells. CONCLUSIONS: Initiating highly active antiretroviral therapy at very early stages of chronic HIV-1 infection allows rapid and almost complete normalization of T cell subsets and preservation of T cell functions. These early-treated patients could be excellent candidates for receiving additional HIV-specific immune-based therapies, which might be essential for the control of HIV infection.
Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Antígenos CD , Terapia Antirretroviral Altamente Activa , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/inmunología , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Subgrupos de Linfocitos T/inmunología , ADP-Ribosil Ciclasa , ADP-Ribosil Ciclasa 1 , Antígenos de Diferenciación/metabolismo , Antígenos CD28/metabolismo , Relación CD4-CD8 , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Enfermedad Crónica , Citocinas/metabolismo , Infecciones por VIH/virología , VIH-1/fisiología , Humanos , Memoria Inmunológica , Activación de Linfocitos , Recuento de Linfocitos , Glicoproteínas de Membrana , NAD+ Nucleosidasa/metabolismo , ARN Viral/sangre , Receptores CCR5/metabolismo , Carga ViralRESUMEN
Therapy with two nucleoside reverse transcriptase inhibitors (NRTI), the backbone of triple combinations, is still widely used in early stages of HIV-1 disease. However, factors influencing virologic response need to be further analyzed, to test the hypothesis that the reduction of plasma RNA viremia with NRTI may be greater in patients with higher baseline viral load (BVL) and to analyze the predictive factors of viral load drop below detection (200 HIV RNA copies/ml of plasma). Selected for the study were 169 HIV-1-infected antiretroviral therapy-naive patients with CD4+ T-lymphocyte counts ranging from 6 to 1040/microl coming from three randomized studies comparing the efficacy of monotherapy (zidovudine [ZDV], 250 mg every 12 hours; N=40) versus two-drug therapy consisting of ZDV (250 mg every 12 hours) with dideoxycytidine (ddC, 0.75 mg every 8 hours) or didanosine (ddI, 200 mg every 12 hours; N=129). Viral load was measured at 1, 3, and 6 months by polymerase chain reaction (PCR). A linear regression model was used to analyze the relation between BVL and the peak reduction of plasma RNA viremia. The variables included in a logistic regression model to determine the likelihood of VLs dropping below detection levels were age, gender, risk group for HIV-1 infection, baseline CD4+ lymphocyte count, BVL, clinical status (AIDS versus non-AIDS), HIV-1 phenotype (syncytium-inducing [SI] versus non-syncytium-inducing [NSI]) and type of treatment (monotherapy versus double therapy). The peak reduction of VL was related to baseline level following a linear model in both monotherapy and double-therapy regimens. In the subgroup of patients treated with two NRTIs, the regression line that fitted best with the data was log10 (peak reduction)=1.8-0.36 log10 (BVL) (F=23.5; p < .0001). This indicates that for every increase of 1 log10 of BVL, the peak reduction would be of 0.64 log10 greater. Forty-nine (29%) of the 169 patients dropped to <200 copies/ml. The likelihood of dropping below detection level was significantly greater in those receiving double therapy versus monotherapy (odds ratio [OR]=16.1; 95% confidence interval [CI], 2-128), in those with baseline CD4+ lymphocyte count >350/microl (OR=2.28; 95% CI, 1.1-4.9) and in those with BVL <10,000 HIV-1 RNA copies/ml (OR= 2.25; 95% CI, 1.1-6.1). None of the 13 patients with an SI phenotype at baseline dropped below detection levels. The reduction of VL in response to two NRTIs was greater in those patients with a higher level of BVL. In conclusion, peak reduction below detection in response to NRTI can be predicted and is associated with double therapy, with a baseline CD4+ cell count >350/microl and with a BVL <10,000 RNA copies/ml.
Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , VIH-1/efectos de los fármacos , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Carga Viral , Adulto , Análisis de Varianza , Fármacos Anti-VIH/farmacología , Didanosina/farmacología , Didanosina/uso terapéutico , Quimioterapia Combinada , Femenino , Células Gigantes/virología , Infecciones por VIH/virología , VIH-1/clasificación , VIH-1/fisiología , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Análisis Multivariante , Fenotipo , Probabilidad , Inhibidores de la Transcriptasa Inversa/farmacología , Factores de Riesgo , Factores de Tiempo , Zalcitabina/farmacología , Zalcitabina/uso terapéutico , Zidovudina/farmacología , Zidovudina/uso terapéuticoAsunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Criptococosis/complicaciones , Osteomielitis/microbiología , Infecciones por Salmonella/complicaciones , Femenino , Humanos , Enfermedades Cutáneas Infecciosas/complicaciones , Enfermedades Cutáneas Infecciosas/microbiologíaRESUMEN
In the last few years a considerable number of imported malaria has been reported in Spain, probably due the increased tourism to areas with endemic malaria, particularly with P. falciparum. This is the species more frequently associated with severe complications and the only one capable of causing cerebral malaria. In this report we review five cases of malaria which required intensive care because of their severity. None of the patients had received chemoprophylaxis. In all cases the admission criterion to the intensive care unit was the organic failure of one or more systems (renal failure and disseminated intravascular coagulation [DIC] mainly) or the presence of changes in the central nervous system. Parasitemia at admission was higher than 5% in all patients. One patient died on account of cerebral malaria. Only one patient had severe complications not directly associated with malaria. In patients who already have severity criteria, a negative parasitemia test during the clinical course does not necessarily implies a clinical improvement nor does it exclude the emergence of complications. On the other hand, a low parasitemic degree is never a contraindication for admission to the intensive care unit when severity criteria are present.
Asunto(s)
Malaria Falciparum , Viaje , Adulto , Femenino , Humanos , Malaria Falciparum/complicaciones , Malaria Falciparum/diagnóstico , Malaria Falciparum/terapia , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
A 0.85-kb HindIII mitochondrial DNA fragment of the dermatophytic fungus Trichophyton mentagrophytes has been sequenced. The fragment contains eight complete genes which corresponds to a tRNA gene cluster. From 5' to 3', the sequenced genes code for tRNA(thr), tRNA(glu), tRNA(val), tRNA(met1), tRNA(met3), tRNA(leu), tRNA(ala), and tRNA(phe). This tRNA gene cluster is located downstream of the larger ribosomal RNA gene. The particularities of the sequenced genes and their comparison with other fungal tRNA mitochondrial genes are reported.
Asunto(s)
ADN Mitocondrial/genética , Familia de Multigenes , ARN de Transferencia/genética , Trichophyton/genética , Secuencia de Bases , Clonación Molecular , ADN de Hongos/genética , ADN Mitocondrial/metabolismo , Desoxirribonucleasa HindIII/metabolismo , Datos de Secuencia Molecular , Conformación de Ácido Nucleico , Mapeo RestrictivoRESUMEN
Freezing and storage at -80 degrees C has been applied to the preservation of nonsporulated filamentous fungi Phytophthora, Pythium, Sclerotinia and Rhizoctonia, and the results are presented. We had tested different methods of freezing and thawing, finding that the best results were obtained pre-cooling at 4 degrees C during 1 hour followed by freezing at -80 degrees C. The best thawing method was achieved at 37 degrees C. The technique was found to be simple and reliable for the culture collections labours of fungi maintenance.
Asunto(s)
Criopreservación/métodos , Hongos Mitospóricos , Micología/métodos , Ascomicetos , Crioprotectores , Glicerol , Phytophthora , Pythium , Rhizoctonia , TemperaturaRESUMEN
A promoter probe library from the dermatophyte fungusTrichophyton mentagrophytes has been constructed in the pVB32 plasmid vector. Using this library, a set ofT. mentagrophytes DNA sequences with promoter activity inEscherichia coli has been cloned. The size and the resistance phenotype conferred by these DNA fragments varied. Southern blot analysis confirmed that they were derived fromT. mentagrophytes genomic DNA.