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Abstract The ability of MALDI-TOF for the identification of nontuberculous mycobacteria (NTM) has improved recently thanks to updated databases and optimized protein extraction procedures. Few multicentre studies on the reproducibility of MALDI-TOF have been performed so far, none on mycobacteria. The aim of this study was to evaluate the reproducibility of MALDI-TOF for the identification of NTM in 15 laboratories in 9 European countries. A total of 98 NTM clinical isolates were grown on Löwenstein-Jensen. Biomass was collected in tubes with water and ethanol, anonymized and sent out to the 15 participating laboratories. Isolates were identified using MALDI Biotyper (Bruker Daltonics). Up to 1330 MALDI-TOF identifications were collected in the study. A score ≥ 1.6 was obtained for 100% of isolates in 5 laboratories (68.2–98.6% in the other). Species-level identification provided by MALDI-TOF was 100% correct in 8 centres and 100% correct to complex-level in 12 laboratories. In most cases, the misidentifications obtained were associated with closely related species. The variability observed for a few isolates could be due to variations in the protein extraction procedure or to MALDI-TOF system status in each centre. In conclusion, MALDI-TOF showed to be a highly reproducible method and suitable for its implementation for NTM identification.

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P

Background: Self-care and empowerment promotion in patients with heart failure (HF) is essential for improving their prognosis, but there is limited information concerning the patients' depth of knowledge about this pathology as well as patient satisfaction within heart failure units (HFUs). Our objective was to assess both aspects in a cohort of patients regularly followed-up HFUs. Methods: A multicenter, observational study was conducted with consecutive patients followed in 14 HFUs between June and November 2023. It was based on a cross-sectional survey comprising 23 questions related to demographics, knowledge/self-care, and the subjective assessment of perceived quality and satisfaction in HFUs. Results: 281 patients were included (36.7% women, 74.7% aged over 65 years). 48% had hospitalizations for HF or sought emergency department services within the preceding year. The mean correct responses related to knowledge were 9.7 ± 2.3 (80.7% of the total), and 53 patients (18.9%) answered all knowledge questions correctly. 211 (79.6%) could identify potential HF decompensation with abrupt weight gain, and 196 (74.2%) recognized at least three additional signs of worsening HF. 266 patients (98.2%) were likely or very likely to recommend HFUs, and 194 (89.8%) positively appreciated the experience at the day hospital. Conclusions: Patients followed up in HFUs showed adequate but improvable knowledge and capacity for self-care, with a high level of satisfaction.

Piroplasms, which include the agents of cattle fever and human and dog babesiosis, are a diverse group of blood parasites of significant veterinary and medical importance. The invasive Asian longhorned tick, Haemaphysalis longicornis, is a known vector of piroplasms in its native range in East Asia and invasive range in Australasia. In the USA, H. longicornis has been associated with Theileria orientalis Ikeda outbreaks that caused cattle mortality. To survey invasive populations of H. longicornis for a broad range of piroplasms, 667 questing H. longicornis collected in 2021 from 3 sites in New Jersey, USA, were tested with generalist piroplasm primers targeting the 18S small subunit rRNA (395–515 bp, depending on species) and the cytochrome b oxidase loci (1009 bp). Sequences matching Theileria cervi type F (1 adult, 5 nymphs), an unidentified Theileria species (in 1 nymph), an undescribed Babesia sensu stricto (‘true’ Babesia, 2 adults, 2 nymphs), a Babesia sp. Coco (also a ‘true Babesia’, 1 adult, 1 nymph), as well as Babesia microti S837 (1 adult, 4 nymphs) were recovered. Babesia microti S837 is closely related to the human pathogen B. microti US-type. Additionally, a 132 bp sequence matching the cytochrome b locus of deer, Odocoileus virginanus, was obtained from 2 partially engorged H. longicornis. The diverse assemblage of piroplasms now associated with H. longicornis in the USA spans 3 clades in the piroplasm phylogeny and raises concerns of transmission amplification of veterinary pathogens as well as spillover of pathogens from wildlife to humans.

Introducción: los pacientes mayores de 65 años son un grupo etario importante en el área de la salud debido a que representan una alta demanda en atención primaria por presentar enfermedades no transmisibles, tales como: hipertensión arterial, diabetes, enfermedad pulmonar crónica; que de no ser tratadas adecuadamente desembocan en complicaciones severas como: enfermedad cerebrovascular, infarto agudo de miocardio, insuficiencia renal, etc. Estas complicaciones son enfermedades de alto costo para el sistema de salud y deben ser atendidas en instituciones de alta complejidad, por lo cual, si no cuentan con un buen acompañamiento profesional intra y extrahospitalario, debido al número de fármacos con los cuales se encuentran usualmente medicados podría desencadenarse de manera individual diversos eventos que afectarían su salud y calidad de vida. Objetivo: identificar las reacciones adversas a medicamentos en pacientes mayores de 65 años, polimedicados y hospitalizados, en una institución de la costa caribe colombiana. Métodos: estudio descriptivo, retrospectivo de corte transversal con componente correlacional, a partir de las historias clínicas, en el periodo abril 2021 a abril 2022. Resultados: se detectaron 88 interacciones de las cuales el 60% fueron clasificadas como de gravedad moderada y 37% seria. La RAM con mayor frecuencia de aparición fue la hipotensión más otros síntomas asociados los cuales estuvieron relacionados con los medicamentos cardiovasculares (62.3%), seguida de la hemorragia de vías digestivas con 30,2%. A mayor número de medicamentos existe mayor probabilidad de desarrollar RAM’s (p= 0,023). Conclusión: es importante la supervisión continua y mejoras en los procesos de prescripción de medicamentos, como también en la coordinación y cuidado en el manejo de pacientes polimedicados mayores de 65 años con múltiples comorbilidades.

Aiming to develop a sustainable separation process reducing the water pollution, in this work Pinus pinaster (cluster pine) bark from a wood veneer industry was used for methylene blue and malachite green removal from aqueous systems. For single adsorption, the influence of time (up 8 h), adsorbent dose (2,5 - 5 - 10 g·L-1), temperature (25 ºC - 40 ºC - 60 ºC), pH (2 - 4 - 6) and particle size (0,1 mm - 0,5 mm, 0,5 mm - 1 mm and 1,6 mm - 2 mm) on adsorption was investigated. To study the initial concentration effect on binary adsorption, different concentrations (0 - 5 - 25 - 50 mg·L-1) were used at 25 ºC, natural pH and a dose of 5 g·L-1. High efficiency was obtained at pH = 4 (natural pH), dose of 5 g·L-1 and particle size of 0,5 - 1 mm. Adsorption percentages higher than 70 % were reached in less than one hour, with removal almost complete at equilibrium in single systems, without temperature influence. Methylene blue was slightly better adsorbed by bark. In binary systems, dyes exhibited competitive adsorption, decreasing their removal, especially increasing the initial concentration of the other dye. Dyes adsorption followed the pseudo-second order kinetic model, whereas the Langmuir isotherm explained adsorption equilibria in mono-component systems. High adsorption capacities (41,7 mg·g-1 for malachite green and 50,0 mg·g-1 for methylene blue) were obtained at 40 ºC and natural pH indicating that pine bark can be effectively used as biosorbent.

This article examines how trauma, crime, violence, and masculinity are connected in the novel Moronga (2018) by Honduran–Salvadoran author Horacio Castellanos Moya. The novel highlights the ways in which, thirty years after the signing of the Peace Accords, war trauma continues to oppress survivors of the civil war and determine their daily lives, beyond temporal and geographical borders. The novel points out how the transition into the neoliberal economy has transnationalized all aspects of the Salvadoran economy, including that of organized crime, which has undergone globalization, as have trauma and Salvadoran communities. Through the novel’s depiction of violence and crime, the author suggests that only those who perpetuate patriarchal violence in postwar diasporic communities will thrive, whereas those who aspire to carry out memory labor and peacefully heal the emotional wounds of the past will be defeated by the perverse logic of the system.

In this paper, an activated carbon obtained from Pinus radiata sawdust is applied to remove blue, red, and black wood dyes from aqueous solutions in a fixed-bed column. The flow rate (7.7–30.8 mL min−1), initial dye concentration (25–500 mg L−1), and bed height (2–4 cm) highly influence the breakthrough-curves’ features. The results indicate that the adsorption capacity increased by decreasing the flow rate and increasing the initial dye concentration, except for the black dye, and increasing bed height, except for the red dye. In addition, the breakthrough time changed by modifying the studied variables. The curves became steeper as the flow rate increased and as the bed height decreased. Also, by increasing the inlet dye concentration, the breakthrough time decreased significantly, and sharper breakthrough curves were obtained. The activated carbon with a surface area of 2826 m2 g−1 led to high values of the adsorption capacity between 150 and 1300 mg g−1. The Yoon–Nelson and Thomas models were the ones that best described the adsorption data. The activated carbon saturated with black dye could be used in three successive cycles after regeneration with H2O2.

Introducción: La población de pacientes con patologías cardiovasculares ha aumentado, estos requieren en su esquema terapéutico un antihipertensivo en combinación con anticoagulantes para la prevención de procesos trombóticos. Estos fármacos pueden dar lugar a interacciones produciendo hipercalemia, estas interacciones ocurren con frecuencia en las clínicas y/o hospitales, sin embargo, en Colombia son pocos los estudios que han evaluado las consecuencias médicas que implica este tratamiento lo que ha originado una visión mucho más pragmática del manejo cotidiano del paciente. Objetivo: describir la hipercalemia inducida por el uso concomitante de Antagonistas de los Receptores de Angiotensina (ARA II) y Heparinas de Bajo Peso Molecular (HBPM) a través de la revisión de artículos científicos relacionados. Métodos: se realizó una selección de artículos científicos publicados entre 2010 a 2020, utilizando el repositorio electrónico de PubMed/ScienceDirect (y artículos de libre acceso en las Bases/Datos de Scopus, MedLine, Scielo y LILACs) según las recomendaciones del tesauro DeCS (Descriptores en Ciencias de la Salud) para operadores lógicos y descriptores sobre esta temática. Resultados: Hasta que se realicen más estudios, es conveniente utilizar con precaución los ARA II y las HBPM combinados entre sí en pacientes con afecciones cardíacas y con secreción tubular de potasio alterada ya que se corre el riesgo de modificar los factores que mantienen el balance de potasio produciéndose hipercalemia. Conclusión: esta revisión describe las bases conceptuales farmacológicas de los ARA II y las HBPM, así como el mecanismo de interacción entre los ARA II y las HBPM relacionados a los factores de riesgo asociados al paciente que conlleva a la hipercalemia y permitió Analizar de manera crítica el algoritmo de detección y prevención desde el ámbito del químico farmacéutico como herramienta de farmacovigilancia.

Introducción: los inhibidores del Factor de Necrosis Tumoral o anti-TNF son medicamentos biológicos utilizados en el tratamiento de procesos inflamatorios crónicos. El adalimumab es un representante de este grupo de fármacos usados en psoriasis en placas, artritis psoriásica reumatoide, etc. Sus antecedentes en reportes del programa farmacovigilancia sobre las reacciones adversas direccionaron el desarrollo de este bioensayo en el nemátodo Caenorhabditis elegans (C. elegans). Objetivo: evaluar la toxicidad de Adalimumab en el modelo biológico C. elegans. Métodos: se realizó un bioensayo en el nemátodo C. Elegans empleando la cepa silvestre N2 y las cepas transgénicas SDO-4, HSP-3, GPX-4 que fueron expuestas a diferentes concentraciones de adalimumab para evaluar su toxicidad. Resultados: las diferentes concentraciones de Adalimumab no alteraron su ciclo de vida del C. elegans, pero si produjeron neurotoxicidad demostrada por sobreexcitación de la locomoción, así como disrupción endocrina además de daño tisular. Conclusión: es necesario contar con más estudios sobre toxicidad para los medicamentos biológicos y contar con programas de Farmacovigilancia, para la notificación de sospecha de toxicidad por estos fármacos.

Global anthropogenic environmental degradations such as climate change are increasingly recognized as critical public health issues, on which human beings should urgently act in order to preserve sustainable conditions of living on Earth. “Planetary Health” is a breakthrough concept and emerging research field based on the recognition of the interdependent relationships between living organisms—both human and non-human—and their ecosystems. In that regards, there have been numerous calls by healthcare professionals for a greater recognition and adoption of Planetary Health perspective. At the same time, current Western healthcare systems are facing their limits when it comes to providing affordable, equitable and sustainable healthcare services. Furthermore, while hospital-centrism remains the dominant model of Western health systems, primary care and public health continue to be largely undervalued by policy makers. While healthcare services will have to adapt to the sanitary impacts of environmental degradations, they should also ambition to accompany and accelerate the societal transformations required to re-inscribe the functioning of human societies within planetary boundaries. The entire health system requires profound transformations to achieve this, with obviously a key role for public health. But we argue that the first line of care represented by primary care might also have an important role to play, with its holistic, interdisciplinary, and longitudinal approach to patients, strongly grounded in their living environments and communities. This will require however to redefine the roles, activities and organization of primary care actors to better integrate socio-environmental determinants of health, strengthen interprofessional collaborations, including non-medical collaborations and more generally develop new, environmentally-centered models of care. Furthermore, a planetary health perspective translated in primary care will require the strengthening of synergies between institutions and actors in the field of health and sustainability.

People often use parks and other forested areas for outdoor activities such as hiking and walking their dogs. Areas of primary use are paths or grassy meadows on the edges of the forests that constitute transitional areas between different plant communities (aka ecotones). In this study, we monitored the seasonal dynamics of questing ticks in forest/meadow and forest/path ecotones in five areas in Middlesex County, New Jersey (NJ). We found anthropophilic species such as Ixodes scapularis, Amblyomma americanum, and Dermacentor variabilis coexisting with Haemaphysalis longicornis, an invasive tick species first detected in NJ in 2017. Surveillance was conducted weekly from March to November 2020, and collected ticks were identified. The most abundant tick species was H. longicornis (83%), followed by A. americanum (9%), I. scapularis (7%), and D. variabilis (A. americanum and I. scapularis in the ecotone were similar to previous surveys in forest habitats. The presence of anthropophilic ticks, particularly I. scapularis, suggests the need for specific control approaches to target these habitats. In addition, the extraordinarily high numbers of H. longicornis collected in ecotones (1.70 ticks/m2) and frequent reports of this species on dogs highlight the importance of monitoring its expansion due to its potential as a vector of animal and human diseases.

Background: Urological chronic pelvic pain syndrome (UCPPS) combines two of the most widespread chronic urological pain disorders: interstitial cystitis (IC)/bladder pain syndrome (BPS) and chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS). This manuscript aims to assess the effectiveness of an outpatient, multimodal treatment protocol for men with UCPPS. Methods: A retrospective study of 58 male patients was done on an institutional review board approved protocol consisting of pelvic floor physical therapy (PFPT) in concomitance with the pelvic floor muscles receiving ultrasound guided trigger point injections and peripheral nerve blocks weekly for six weeks. Patients rated their levels of pelvic pain, performance, and quality of life via Visual Analogue Scale (VAS), Functional Pelvic Pain Scale (FPPS), and NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) at their new patient consult and 3-month follow up. Results: Initial average VAS was 6.24 ± 2.26 and average VAS after treatment reduced to 4.25 ± 2.8. Initial average FPPS score was 9.21 ± 5.24. Final average FPPS reduced to 7.28 ± 5.03. Initial average total NIH-CPSI score was 24.55 ± 6.43 and after treatment reduced to 18.36 ± 7.62. Initial average NIH-CPSI pain, urinary symptoms, and quality of life sub scores were 11.28 ± 3.46, 3.41 ± 3.31, and 9.86 ± 2.05, respectively. After treatment, they decreased to 8.34 ± 4.14, 2.47 ± 2.45, and 7.55 ± 2.74. Differences in pre and post treatment outcomes were statistically significant. Conclusions: This shows the protocol was successful at improving pain and performance in male UCPPS patients. This supports the validity of a multimodal treatment protocol given patients failed to improve after a full course of PFPT by itself. However, they improved once PFPT was combined with other treatment modalities, alleviating the underlying neuropathic and myofascial pain seen in UCPPS.

(1) Background: Q fever is a worldwide zoonosis caused by Coxiella burnetii that have cases reported in humans and animals almost everywhere. The aim of this study was to describe the seasonality of Coxiella burnetii in the wild rabbit (Oryctolagus cuniculus) and the tick Hyalomma lusitanicum in a meso-Mediterranean ecosystem. (2) Methods: two populations of wild rabbits that differ in whether or not they share habitat with ungulates, mainly red deer (Cervus elaphus) were sampled for a year to collect ticks, blood and vaginal or anal swabs. Presence of C. burnetii DNA in swabs and the tick H. lusitanicum was determined by PCR and serum antibodies by ELISA. (3) Results: C. burnetii DNA was detected in 47.2% of 583 rabbits, in 65.5% of sera, and in more than half of the H. lusitanicum. There were small variations according to sex and age of the rabbits but significant according to the habitat (4) Conclusions: The results indicate that C. burnetii circulates freely between wild rabbits and H. lusitanicum and the sylvatic cycle in meso-Mediterranean environments relies in the presence of wild rabbits and H. lusitanicum above all if sharing habitat with red deer.