Are any specific respiratory viruses more severe than others in recipients of allogeneic stem cell transplantation? A focus on lower respiratory tract disease

In the general population, influenza virus, respiratory syncytial virus, and SARS-CoV-2 are considered the most severe community-acquired respiratory viruses (CARVs). However, allogeneic stem cell transplant (allo-SCT) recipients may also face severe courses from other CARVs. This retrospective study compared outcomes of various CARV lower respiratory tract diseases (LRTD) in 235 adult allo-SCT recipients, excluding co-infection episodes. We included 235 adults allo-SCT recipients experiencing 353 CARV LRTD consecutive episodes (130 rhinovirus, 63 respiratory syncytial virus, 43 influenza, 43 human parainfluenza virus, 23 human metapneumovirus, 19 Omicron SARS-CoV-2, 17 common coronavirus, 10 adenovirus and 5 human bocavirus) between December 2013 and June 2023. Day 100 overall survival ranged from 78% to 90% without significant differences among CARV types. Multivariable analysis of day 100 all-cause mortality identified corticosteroid use of >1 to <30 mg/d [Hazard ratio (HR) 2.45, p = 0.02) and ≥30 mg/d (HR 2.20, p = 0.015) along with absolute lymphocyte count <0.2 × 109/L (HR 5.82, p < 0.001) and number of CARV episodes as a continuous variable per one episode increase (HR 0.48, p = 0.001) as independent risk factors for all-cause mortality. Degree of immunosuppression, rather than intrinsic CARV virulence, has the most significant impact on mortality in allo-SCT recipients with CARV-LRTD.

Outcome of Human Parainfluenza Virus infection in allogeneic stem cell transplantation recipients: possible impact of ribavirin therapy

BACKGROUND

This retrospective study focused on analyzing community-acquired respiratory virus (CARV) infections, in particular human parainfluenza virus (hPIV) after allogeneic stem cell transplant (allo-SCT) in adults recipients. It aimed to assess the impact of ribavirin treatment, clinical characteristics, and risk factors associated with lower respiratory tract disease (LRTD) progression and all-cause mortality.

PATIENTS AND METHODS

The study included 230 allo-SCT recipients diagnosed with hPIV between December 2013 and June 2023. Risk factors for the development of LRTD, disease severity, and mortality were analyzed. Ribavirin treatment was administered at physician discretion in 61 out of 230 cases (27%).

RESULTS

Risk factors for LRTD progression in multivariate analysis were corticosteroids > 30 mg/day (Odds ratio (OR) 3.5, 95% Confidence Interval (C.I.) 1.3-9.4, p = 0.013), fever at the time of hPIV detection (OR 3.89, 95% C.I. 1.84-8.2, p < 0.001), and absolute lymphocyte count (ALC) < 0.2 × 109/L (OR 4.1, 95% C.I. 1.42-11.9, p = 0.009). In addition, the study found that ribavirin therapy significantly reduced progression to LRTD [OR 0.19, 95% C.I. 0.05-0.75, p = 0.018]. Co-infections (OR 5.7, 95% C.I. 1.4-23.5, p = 0.015) and ALC < 0.2 × 109/L (OR 17.7, 95% C.I. 3.6-87.1, p < 0.001) were independently associated with higher day + 100 after hPIV detection all-cause mortality. There were no significant differences in all-cause mortality and infectious mortality at day + 100 between the treated and untreated groups.

CONCLUSION

ALC, corticosteroids, and fever increased the risk for progression to LRTD while ribavirin decreased the risk. However, mortality was associated with ALC and co-infections. This study supports further research of ribavirin therapy for hPIV in the allo-HSCT setting.

CHALLENGING THE DOGMAS: LAPAROSCOPIC COMMON BILE DUCT EXPLORATION THROUGH DIATHERMY, CHOLEDOCHOTOMY AND PRIMARY CLOSURE. LONG TERM OUTCOMES IN A REFERRAL CENTER

Introduction

Choledocholithiasis is a frequent pathology, unfortunately when its endoscopic management fails there is no consensus on how it should be addressed. The aim of this study was to evaluate the safety, feasibility and long-term outcomes of laparoscopic common bile duct exploration (LCDBE) using electrosurgery (coagulation) for choledochotomy followed by primary closure after endoscopic treatment failure.

Methods

A retrospective cohort of 168 patients who underwent LCDBE from 2013 to 2018 which was conducted all by choledochotomy. Clinical demographics, operative outcomes, recurrence rate of CBD stones, and long-term bile duct complications were analyzed.

Results

The male/female ratio was 90/78 and mean age was 73 years. Stone clearance was successful in 167 patients (99.4%). Nonlethal complications were noted in 3 patients during the surgery or in the immediate postoperative (1.79%) and managed with T-tube or endoscopically. No cases of surgery-related mortality were observed. There were no signs of any type of biliary injury or stricture observed in any of the patients during the 24-month follow-up period.

Conclusions

LCBDE through choledochotomy with diathermy and primary closure can be performed without increased risk of operative complications such as important and visual-impairment bleeding as well as long-term complications such as bile duct stricture or recurrent CBD stones. LCBDE with diathermy and primary closure is a safe and effective treatment option for choledocholithiasis for failed ERCP in terms of long-term outcome as well as short-term outcome.

Intermediate snowpack melt-out dates guarantee the highest seasonal grasslands greening in the Pyrenees

In mountain areas, the phenology and productivity of grassland are closely related to snow dynamics. However, the influence that snow melt timing has on grassland growing still needs further attention for a full understanding, particularly at high spatial resolution. Aiming to reduce this knowledge gap, this work exploits 1 m resolution snow depth and Normalized Difference Vegetation Index observations acquired with an Unmanned Aerial Vehicle at a sub-alpine site in the Pyrenees. During two snow seasons (2019-2020 and 2020-2021), 14 NDVI and 17 snow depth distributions were acquired over 48 ha. Despite the snow dynamics being different in the two seasons, the response of grasslands greening to snow melt-out exhibited a very similar pattern in both. The NDVI temporal evolution in areas with distinct melt-out dates reveals that sectors where the melt-out date occurs in late April or early May (optimum melt-out) reach the maximum vegetation productivity. Zones with an earlier or a later melt-out rarely reach peak NDVI values. The results obtained in this study area, suggest that knowledge about snow depth distribution is not needed to understand NDVI grassland dynamics. The analysis did not reveal a clear link between the spatial variability in snow duration and the diversity and richness of grassland communities within the study area.

Evolution of argoma shrubland (Ulex gallii Planch.) after clearing and burning treatments in Sierra de Aralar and Belate (Navarra)

Shrub encroachment is considered one of the greatest threats in the conservation of pastures, especially in abandoned territories and territories with low stocking density. However, in the Navarra Pyrenees and Basque mountains, with a high stocking density maintained during the last decades, the expansion of argoma shrubland (Ulex gallii), shows that grazing is not enough for its control and requires evaluating measures of clearing. To evaluate the efficiency of the burning and the mechanical clearing (with two treatments: at ground level and 10 cm above ground) in the control of the shrub, these treatments were applied in different plots of encroached grasslands in two pastoral territories (Sierra de Aralar and Belate). After the burning and clearing, the evolution of the shrub was compared in the cleared plots closed to grazing and in their replicas open to it. The results showed differences between the different treatments in both territories that may be related to the initial coverage of the shrubland. In general, burning was less effective in controlling shrubland and allowed a greater resprout than mechanical clearing. No significant differences were found between the two types of mechanical clearing (at ground level and at 10 cm above ground). Finally, grazing caused a delay in the recovery of the shrub in all casesbut it was not able to eliminate the shrubs completely. From the field observations, the opinions of the farmers and the results of similar experiences, some measures for grassland management were collected and discussed to correct or complement the clearing treatments in order to increase their efficiency.

Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset

BACKGROUND

Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension.

AIM

To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis.

METHODS

Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed.

RESULTS

Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained.

CONCLUSION

In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.

Field Performance of Cryopreserved Seed-derived Maize Plants

BACKGROUND

Cryo-preservation of plant materials in liquid nitrogen (LN) has been described as a suitable technology to conserve genetic resources of several species. However, the potential effects of LN in the subsequent plant growth in the field should be studied before large-scale implementation of cryopreserved germplasm banks.

OBJECTIVE

To describe the field performance of cryopreserved seed-derived maize adult plants.

MATERIALS AND METHODS

Germination percentage and numbers of leaves and ears per plant, internodes in stems, middle - aged leaf length, plant height, ear traits and weight of 100 seeds were recorded.

RESULTS

Statistically significant differences between adult plants derived from cryopreserved seeds and the control treatment were not observed (t-test, p=0.05).

CONCLUSION

The results presented confirm at the phenotype level the effectiveness of maize seed cryostorage to preserve and regenerate true-to-type plants.

Distribución espacial y análisis ambiental de la flora vascular de los Pirineos

La reciente publicación web del Atlas de la flora vascular de los Pirineos permite ahora delimitar la diversidad florística de la cordillera y analizar su distribución territorial y algunas afinidades ambientales con el fin de contribuir a su caracterización ecológica y a su conservación. La flora vascular de los Pirineos reúne 3.652 plantas vasculares autóctonas, incluyendo especies y subespecies, lo que sitúa a la cordillera como el segundo núcleo de diversidad florística en Europa, tras los Alpes. Entre los seis sectores geográficos considerados, los que albergan mayor riqueza de plantas son el Central-Sur (76% del total) y los dos orientales (ambos con el 75%). En el gradiente altitudinal, el piso montano es el que alberga mayor número de taxones (87% del total). Respecto a la corología, el 32% de la flora pirenaica son plantas eurosiberianas, el 29% mediterráneas, las orófitas alpinas y boreoalpinas son el 12,6% y los endemismos un 5%. Por sus formas biológicas, predominan los hemicriptófitos (40%) y los terófitos (20,4%). Conforme se asciende en altitud, aumentan los caméfitos y disminuyen los terófitos. Por su preferencia edáfica, un 35% de la flora es calcícola y un 21% silicícola. En cuanto a la representación por hábitats, cerca del 30% de las plantas viven en pastos, el 16% en humedales, los ambientes rocosos, bosques, matorrales y comunidades ruderales albergan un número similar de plantas (entre el 12 y 13% cada uno). Por último, teniendo en cuenta la naturalidad de los hábitats, el 47% de las plantas vive en los de alta o muy alta naturalidad, aunque cerca de una cuarta parte se encuentra en los más humanizados.

Increased levels of adenosine and ecto 5'-nucleotidase (CD73) activity precede renal alterations in experimental diabetic rats

The pathogenesis of diabetic nephropathy (DN) has not been clearly established, making diagnosis and patient management difficult. Recent studies using experimental diabetic models have implicated adenosine signaling with renal cells dysfunction. Therefore, the study of the biochemical mechanisms that regulate extracellular adenosine availability during DN is of emerging interest. Using streptozotocin-induced diabetic rats we demonstrated that urinary levels of adenosine were early increased. Further analyses showed an increased expression of the ecto 5'-nucleotidase (CD73), which hydrolyzes AMP to adenosine, at the renal proximal tubules and a higher enzymatic activity in tubule extracts. These changes precede the signs of diabetic kidney injury recognized by significant proteinuria, morphological alterations and the presence of the renal fibrosis markers alpha smooth muscle actin and fibronectin, collagen deposits and thickening of the glomerular basement membrane. In the proximal tubule cell line HK2 we identified TGF-β as a key modulator of CD73 activity. Importantly, the increased activity of CD73 could be screened in urinary sediments from diabetic rats. In conclusion, the increase of CD73 activity is a key component in the production of high levels of adenosine and emerges as a new tool for the early diagnosis of tubular injury in diabetic kidney disease.

Biofilm colonisation in nasolacrimal stents

PROBLEM/OBJECTIVE

Nasolacrimal duct obstruction is a common problem. A Song stent is a useful and simple treatment with low morbidity. However, the success rate is limited, especially in long-term follow-up. The aim of the present study is to determine the presence of biofilms in failing nasolacrimal stents.

METHODOLOGY

Thirty-three polyurethane nasolacrimal stents were implanted between January 2006 and December 2007 using Song's technique. Patients were followed for a mean of 21.5 months (range 11-30 months). Removed nasolacrimal stents were preserved in saline and examined using environmental scanning electron microscopy (ESEM).

RESULTS

Eighteen nasolacrimal stents were removed because of the failure of the device (follow-up range 11-30 months). Seven stents were recovered for this study. Biofilms were identified in all the specimens studied. Five prostheses showed occlusion caused by mucus or granulation tissue.

CONCLUSIONS

Biofilm colonisation of nasolacrimal stents could play a major role in prosthetic failure leading to stent occlusion. Mucus, granulation tissue and irregularities of the biomaterial are factors that facilitate biofilm colonisation. Non-stick material for newly developed stents or drugs capable of destroying the polysaccharide matrix should be considered as future therapeutic options.

Community involvement in dengue vector control: cluster randomised trial

OBJECTIVE

To assess the effectiveness of an integrated community based environmental management strategy to control Aedes aegypti, the vector of dengue, compared with a routine strategy. Design Cluster randomised trial. Setting Guantanamo, Cuba. Participants 32 circumscriptions (around 2000 inhabitants each). Interventions The circumscriptions were randomly allocated to control clusters (n=16) comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach.

MAIN OUTCOME MEASURES

The primary outcome was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of Ae aegypti per 100 inspected houses), Breteau index (number of containers positive for immature stages of Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of Ae aegypti pupae per inhabitant).

RESULTS

All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the Aedes infestation levels were comparable between intervention and control clusters: house index 0.25% v 0.20%, pupae per inhabitant 0.44 x 10(-3) v 0.29 x 10(-3). At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76).

CONCLUSION

A community based environmental management embedded in a routine control programme was effective at reducing levels of Aedes infestation. Trial Registration Current Controlled Trials ISRCTN88405796.

Positron-annihilation-lifetime response and broadband dielectric relaxation spectroscopy: diethyl phthalate

We report the results of a combined phenomenological analysis of the data from positron-annihilation-lifetime spectroscopy (PALS) and the relaxation data from broadband dielectric spectroscopy (BDS) on diethyl phthalate (DEP). The ortho-positronium (o-Ps) lifetime, tau3, as a function of temperature over a temperature range from 67 K up to 300 K is compared with the spectral features and the relaxation parameters of the BDS spectra decomposed into the primary alpha and the secondary beta processes in the temperature range from 140 K up to 380 K by using the Williams-Watts scheme. Phenomenological model-free analysis of the tau3-T plot provides the three characteristic PALS temperatures, where the two most pronounced ones at TgPALS=185 K and Tb2=245 K=1.32TgPALS are related to the glass-liquid transition and the onset of a quasiplateau region, respectively. In the case of a weaker bend effect at Tb1=210 K=1.14TgPALS, a number of new coincidences with changes in the dielectric beta process have been found. They concern the changes in width parameter of the distribution function for the beta relaxation time and the activation energy of the betaeff process, a crossover from the Arrhenius to the non-Arrhenius type of temperature dependence as well as with the onset of a short-time tail of the beta relaxation time distribution and finally, with changes in the relaxation strength of the alpha and betaeff processes. All these findings indicate a close connection of the o -Ps annihilation parameters and relaxation characteristics of BDS response for the DEP matrix.

Chromosomal variation and genome size support existence of cryptic species of Triatoma dimidiata with different epidemiological importance as Chagas disease vectors

The wide geographical distribution of Triatoma dimidiata, one of the three major vectors of Chagas disease, ranges from Mexico to northern Peru. Since this species occupies a great diversity of artificial and natural ecotopes, its eradication is extremely difficult. In order to assist control efforts, we used chromosome analyses and DNA amount as taxonomic markers to study genetic variability in populations of T. dimidiata from Mexico, Guatemala, El Salvador and Colombia. We differentiated three groups or cytotypes defined by characteristic chromosome C-banding patterns and genome size measured by flow cytometry. The three cytotypes are restricted to different geographic locations. Cytotype 1 occurs in Mexico (excluding Yucatán), Guatemala (excluding Petén), El Salvador and Colombia. Cytotype 2 occurs in Yucatán and cytotype 3 occurs in Petén. Cytotype 1, commonly associated with domestic and peridomestic environments but also inhabiting sylvatic ecotopes, is the most widespread and with major epidemiological significance. In contrast, the Yucatán cytotype inhabits wild ecotopes but increasingly enters houses, while the Petén cytotype appears exclusively sylvatic. We suggest that these cytotypes represent cryptic species of T. dimidiata with different epidemiological relevance as Chagas disease vectors. Poor ability to colonize human dwellings, together with their restricted geographic distribution, indicate that the Yucatán and Petén putative species probably have much less epidemiological significance than cytotype 1. Thus, the genetic markers we describe are powerful tools to differentiate cryptic species in T. dimidiata with different epidemiological significance, contributing to planning the most effective control measures.

Mutation analysis of Wilson disease in the Spanish population -- identification of a prevalent substitution and eight novel mutations in the ATP7B gene

Wilson disease (WD) is a copper metabolism disorder characterized by hepatic and/or neurological damage. More than 200 mutations in the ATP7B gene causing this autosomal recessive defect have been reported. In certain populations, a high prevalence of particular mutations allows rapid screening and diagnosis of the disease. We identified the ATP7B alterations in Spanish patients with WD. Mutations in the ATP7B gene were analysed in a total of 64 individuals from 40 different WD families by PCR amplification, single-strand conformation polymorphism (SSCP) analysis and sequencing. Twenty-one different ATP7B gene mutations were identified, eight of which were novel. 74% of the disease alleles were characterized among the 40 unrelated probands. We identified a prevalent mutation in our population (Met645Arg), present in 55% of this 40 patients. The frequency of the remaining ATP7B alterations was low. In addition, 17 different polymorphic variants were found. There is remarkable allele heterogeneity in WD in the Spanish population. Nevertheless, SSCP screening for the most frequent mutations in our population is feasible and leads to the detection of about 74% of the mutated chromosomes. Molecular diagnosis of WD is very useful in clinical practice to confirm or support clinical suspicion.

Soil Characterization by Energy Dispersive X-Ray Fluorescence: Sampling Strategy for in situ Analysis

This work describes a sampling strategy that will allow the use of portable EDXRF (energy dispersive X-ray fluorescence) instruments for "in situ" soil analysis. The methodology covers a general approach to planning field investigations for any type of environmental studies and it was applied for a soil characterization study in the zone of Campana, Argentina, by evaluating data coming from an EDXRF spectrometer with a radioisotope excitation source. Simulating non-treated sampled as "in situ" samples and a soil characterization for Campana area was intended. "In situ" EDXRF methodology is a powerful analytical modality with the advantage of providing data immediately, allowing a fast general screening of the soil composition.

[Value of Aspergillus galactomannan antigen detection in the diagnosis and follow-up of invasive aspergillosis in hematological patients]

Serum galactomannan detection is considered to be a useful test for early diagnosis and follow-up of invasive aspergillosis. From February to September 2002, adult patients hospitalized in our Hematology Unit for receiving intensive chemotherapy and/or hematopoietic stem cell transplant were prospectively studied. We analyzed a total of 760 samples obtained from 100 patients. Eleven patients (11%) having a positive result (OD index >1.5 ng/ml) in two consecutive Platelia Aspergillus tests were considered galactomannan-positive cases. On the other hand, 12 patients (12%) were diagnosed of proven or probable invasive aspergillosis. Sensitivity (66.6%), specificity (95.5%), positive predictive value (72.7%) and negative predictive value (96.7%) were comparable to those of larger series. Galactomannan positivity allowed also to anticipate invasive aspergillosis diagnosis (from two to 17 days before radiographic findings and from two to 15 days before mycological culture). Moreover, kinetics of antigenemia could be useful for assessing therapeutic response. Once accepted galactomannan test as a diagnostic criterium for invasive aspergillosis knowing potential causes of false positive results is of paramount importance.