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T cells play a fundamental role in the processes that mediate graft rejection, tolerance, and defense against infections. The CXCR3 and CCR6 receptors, highly expressed in Th1 (type 1 T helper cells)/Tc1 (T cytotoxic cells, type 1), Th1-Tc1, and Th17-Tc17 lymphocytes, respectively, participate in cell migration toward inflamed tissues. The altered expression level of CXCR3 and CCR6 has been associated with different clinical events after renal transplantation, such as acute rejection (AR) and chronic graft dysfunction, but data are still limited. In this study, we evaluated the expression of the receptor CXCR3 and CCR6 in peripheral blood T lymphocytes from kidney transplant recipients (KTR) and their association with viral infections, AR, and allograft function.Through flow cytometry, the peripheral blood expression of CXCR3 and CCR6 in T cells was evaluated in a pretransplant collection of KTR. The levels of these T subpopulations and their association with the incidence of AR, kidney graft function, viral infections, cytomegalovirus, and BK virus were studied. Adverse clinical events and graft function were monitored during the first year post transplant.KTRs with low pretransplantation levels of Th17 (CD4+CXCR3-CCR6+) (tertile 1, Th1716.4%) had a higher risk of suffering AR during the first year post transplantation (P = .033). KTRs with viral infections or reactivations during the first 3 months post transplantation had significantly lower levels of Tc17 (CD8+CXCR3-CCR6+) and higher levels of Th1 (CD4+CXCR3+CCR6-). In patients with cytomegalovirus reactivations, the viral peak correlates negatively with the pretransplant levels of Th1 (r = -0.606, P = .037).Pretransplantation assessment of Th1-Th17 and Tc1-Tc17 levels may help predict post-transplant clinical events such as AR and reactivation of viral infections.

The predictive coding theory of allostatic-interoceptive load states that brain networks mediating autonomic regulation and interoceptive-exteroceptive balance regulate the internal milieu to anticipate future needs and environmental demands. These functions seem to be distinctly compromised in behavioral variant frontotemporal dementia (bvFTD), including alterations of the allostatic-interoceptive network (AIN). Here, we hypothesize that bvFTD is typified by an allostatic-interoceptive overload.We assessed resting-state heartbeat evoked potential (rsHEP) modulation as well as its behavioral and multimodal neuroimaging correlates in patients with bvFTD relative to healthy control subjects and patients with Alzheimer's disease (N = 94). We measured 1) resting-state electroencephalography (to assess the rsHEP, prompted by visceral inputs and modulated by internal body sensing), 2) associations between rsHEP and its neural generators (source location), 3) cognitive disturbances (cognitive state, executive functions, facial emotion recognition), 4) brain atrophy, and 5) resting-state functional magnetic resonance imaging functional connectivity (AIN vs. control networks).Relative to healthy control subjects and patients with Alzheimer's disease, patients with bvFTD presented more negative rsHEP amplitudes with sources in critical hubs of the AIN (insula, amygdala, somatosensory cortex, hippocampus, anterior cingulate cortex). This exacerbated rsHEP modulation selectively predicted the patients' cognitive profile (including cognitive decline, executive dysfunction, and emotional impairments). In addition, increased rsHEP modulation in bvFTD was associated with decreased brain volume and connectivity of the AIN. Machine learning results confirmed AIN specificity in predicting the bvFTD group.Altogether, these results suggest that bvFTD may be characterized by an allostatic-interoceptive overload manifested in ongoing electrophysiological markers, brain atrophy, functional networks, and cognition.

Rosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our patients with rosacea.Retrospective cohort study of all patients who underwent patch testing in our skin allergy clinic between May 1991 and May 2019.A total of 200 patients with rosacea were referred to our clinic for patch testing during the study period; they represented 2.1% of all patch tested patients in the period. Eighty-one percent were women (mean age, 44.7years). At least 1 positive patch test was recorded for 46.5%; 15% were of current relevance. The most frequent positive reaction was to nickel (26%), followed by cobalt chloride (6.5%), isothiazolinones (6%), p-phenylenediamine (5.5%), fragrance mix II (5%), and thimerosal (3.5%). The most common currently relevant patch test reactions were to isothiazolinones in 10 of the 200 patients (5%); to phenylenediamine, fragrance mix II, and toluensulfonamide formaldehyde resin in 4 patients (2%) each; and to tixocortol and fragrance mix I in 2 patients (1%) each. The allergen groups most often implicated were metals (of current relevance in 12.6%) and drugs (of current relevance in 25.8%). Preservatives and fragrances were the next most common allergen groups, and 70.8% and 43.7% of the positive reactions in these groups, respectively, were of current relevance. Cosmetics were the most frequent source of sensitization, followed by topical medications-notably corticosteroids and antifungal agents.We emphasize the high prevalence of allergic contact dermatitis in patients with rosacea, a finding which supports patch testing, especially if eruptions worsen when these patients use cosmetics and topical medications.

Resumen: Objetivo: Valorar el proceso de prescripción y la mejora de la autoestima y la calidad de vida relacionada con la salud en un estudio piloto de prescripción de activos de actividad física durante 3 meses. Método: Estudio cuasiexperimental antes-después sin grupo control, para la valoración del proyecto piloto (noviembre de 2017 y mayo de 2018) del programa Conecta Actius per a la Salut en seis centros de salud de la Comunitat Valenciana. Quienes aceptaron participar cumplimentaron un cuestionario con datos sociales, la escala de autoestima de Rosemberg y el cuestionario de calidad de vida EQ-5D al inicio (T0) y a los 3 meses (T1). Se realizó un análisis descriptivo por sexo, nivel educativo y oferta de activos, en el que se calcularon las diferencias de medianas entre T0 y T1 mediante el test de Wilconxon para dos muestras relacionadas. Resultados: Respondieron 82 personas en T0 y 78 en T1. Se observa una mejora de la calidad de vida (7%; p ≤0,001), la percepción de salud (12,5% p ≤0,001) y la autoestima (5,9%; p ≤0,001) entre T0 y T1. Las mujeres mejoran en mayor proporción que los hombres para las tres escalas medidas, y quienes tienen mayor nivel educativo o les han realizado la prescripción en los centros que ofertan un único activo. Conclusión: Se han obtenido beneficios en salud a corto plazo tras la prescripción de actividad física. En concreto, se observa una mejora en la calidad de vida, la percepción de salud y la autoestima. Abstract: Objective: Assess the prescription process, adherence and impact on health measured in improvement of self-esteem and health-related quality of life, as short-term health indicators, from a pilot study of prescription of physical activity assets for 3 months. Method: Quasi-experimental study before-after without a control group, for the evaluation of the pilot phase (November 2017 and May 2018) of the program Conecta Actius per a la Salut in the Valencian Community (Spain). The physical activity prescription was performed and a questionnaire was completed at the beginning (T0) and at 3 months (T1). A descriptive analysis was carried out by sex and educational level where the differences between T0 and T1 were calculated using chi square and the Wilcoxon test of two dependent samples. Results: The sample was 82 in T0 and 78 people in T1. The analysis shows an improvement between quality of life (7%; p ≤0.001), health perception (12,5%; p ≤0.001) and self-esteem (5,9%; p ≤0.001) between T0 and T1. The improvement proportion in Health perception is greater in women than in men for the three measured scales and in those who have a higher educational level or have been prescribed in centers that offer a single asset. Conclusion: Pilot study shows short-term health benefits after the physical activity prescription. Specifically, there is an improvement in the quality of life, health perception and self-esteem of the population.

Resumen Antecedentes La asociacion entre los inhibidores de la dipeptidil peptidasa 4 (iDPP-4) y el penfigoide ampolloso (PA) se ha demostrado en varios estudios. El objetivo principal de este estudio era estimar el uso del tratamiento con iDPP-4i en pacientes diagnosticados de PA en nuestro entorno Material y metodos Seleccionamos pacientes diagnosticados histologicamente de PA en nuestro departamento entre octubre de 2015 y octubre de 2018. Realizamos una revision retrospectiva para evaluar los datos clinicos-epidemiologicos y los patrones de inmunofluorescencia directa (IFD). Resultados De los 70 pacientes diagnosticados con PA durante el periodo de estudio, el 50% eran diabeticos y el 88,57% de ellos estaban siendo tratados con un iDPP-4 en el momento del diagnostico de PA. El iDPP-4 mas frecuente era la linagliptina (utilizada en el 18,6% de los pacientes), seguida de la vildagliptina (el 17,1%). La mediana de tiempo de latencia entre el inicio del tratamiento con iDPP-4 y el diagnostico de PA fue de 27,5 meses, siendo de 16 meses para la linagliptina y 39 meses para la vildagliptina (log Rank Conclusion El tratamiento con DPP-4i es muy comun en pacientes con BP en nuestro entorno. El periodo de latencia entre el inicio del tratamiento y el inicio de la PA parece ser mas corto con linagliptina que con otros tipos de gliptinas. Los pacientes que reciben tratamiento con DPP-4i pueden mostrar patrones DIF diferentes a los que no reciben tratamiento

The association between dipeptidyl peptidase 4 inhibitors (DPP-4i) and bullous pemphigoid (BP) has been demonstrated in several studies. The main aim of this study was to estimate the use of DPP-4i treatment in patients diagnosed with BP in our setting.We selected patients histologically diagnosed with BP in our department between October 2015 and October 2018 and performed a retrospective chart review to assess clinical and epidemiological data and direct immunofluorescence (DIF) patterns.Of the 70 patients diagnosed with BP during the study period, 50% were diabetic and 88.57% of these were being treated with a DPP-4i when diagnosed with BP. The most common DPP-4i was linagliptin (used in 18.6% of patients), followed by vildagliptin (17.1%). The median latency period between initiation of DPP-4i treatment and diagnosis of BP was 27.5 months for all treatments, 16 months for linagliptin, and 39 months for vildagliptin (log rank 0.01). A negative DIF result was significantly more common in patients not being treated with a DPP-4i. The DIF pattern most strongly (and significantly) associated with DPP-4i treatment was linear immunoglobulin G deposits along the dermal-epidermal junction. DPP-4i treatment was withdrawn in 87% of patients and 96% of these achieved a complete response.DPP-4i treatment is very common in patients with BP in our setting. The latency period between start of treatment and onset of BP seems to be shorter with linagliptin than with other types of gliptins. Patients receiving DPP-4i treatment may show different DIF patterns to those not receiving treatment.

Background Syphilis is a sexually transmitted infection caused by Treponema pallidum, subspecies pallidum. As these bacteria are difficult to culture, syphilis must be diagnosed by serologic testing. The introduction of automated treponemal tests has led to changes in the traditional diagnostic algorithm for syphilis, which began with a nontreponemal test. We present 15 cases of primary syphilis detected using these new tools and review the microbiologic techniques used for the diagnosis of early syphilis. Material and methods We examined all cases of syphilis diagnosed in our department between January 2013 and September 2018 and selected patients with negative nontreponemal (rapid plasma reagin [RPR]) tests. Results Of the 158 patients diagnosed with syphilis during the study period, 15 had a negative RPR test, and 14 of them had a positive treponemal test. Fourteen of the patients were men and ages ranged from 22 to 60 years. Polymerase chain reaction was used to detect T pallidum in the lesion exudate from 8 patients and was positive in all cases. The 15 patients were treated with a single injection of 2.4 million units of benzathine penicillin G. Conclusion Chemiluminescence immunoassays and T pallidum automated enzyme-linked immunoassays are useful in the diagnosis of early syphilis, and we believe that they should be adopted as screening tools given their diagnostic sensitivity, speed, and low cost.

Background and objective The epidemiology of genital herpes has changed in recent years with an increase in the incidence of herpes simplex virus type 1 (HSV-1) infection. The aim of this study was to analyze the clinical and epidemiological characteristics of patients diagnosed with genital herpes. Material and methods We designed a descriptive, observational study to analyze all cases of genital herpes diagnosed at a sexually transmitted infections (STI) clinic in Valencia, Spain. Results We identified 895 STI diagnoses. Of these, 126 (14%) were genital herpes; 68 (54%) of these cases were in women and 58 (46%) in men. Diagnosis was confirmed by molecular detection of HSV DNA in 110 cases (87.3%). Of these, 52 were cases of HSV-1 infection (47.3%) and 58 were HSV-2 infection (52.7%). HSV-2 was more common in men (69.5%), while HSV-1 was more common in women (59.3%). In the subgroup of women, mean age at diagnosis was 26 years for HSV-1 and 34 years for HSV-2 (P = .015). Recurrent genital herpes rates were 13% for HSV-1 and 40% for HSV-2. Conclusions There has been an increase in the number of cases of genital herpes caused by HSV-1 in our setting, with young women in particular being affected. This has important prognostic implications because genital herpes caused by HSV-1 is less likely to recur.

The digital age is making more datasets available through the Internet, but their interoperability is still limited. The Semantic Web should play a fundamental role in achieving interoperable datasets. The semantic exploitation of data requires its efficient transformation into semantic formats and the integration of heterogeneous sources. Either the scalability of the existing tools for the semantic transformation of large volumes of data is limited or these tools do not provide a semantics-rich representation of the data. The goal of this work was to show how scalable semantic data transformation processes can be designed and implemented, thereby addressing the first limitation mentioned above. Here, we propose an application of high-performance computing techniques to overcome the scalability limitation. The proposed method was implemented as an upgrade of our Semantic Web Integration Tool (SWIT). Additional improvements for supporting the transformation process in SWIT are also described in this paper. We evaluated the new method by using three case studies from the areas of bioinformatics, movies and persons. The results showed a significant speed-up with respect to the original SWIT algorithm and the related tools. The lessons learnt in our work allowed us to configure semantic transformation processes efficiently.

Resumen Introduccion La incidencia de uretritis por Haemophilus esta aumentando. Nuestro objetivo principal es describir las caracteristicas clinico-microbiologicas de estos pacientes. Como objetivo secundario discutiremos el tratamiento mas adecuado en funcion de las resistencias antibioticas testadas. Material y metodos Seleccionamos los pacientes de la Unidad de Infecciones de Transmision Sexual diagnosticados microbiologicamente de uretritis entre julio de 2015 y julio de 2018. De ellos, seleccionamos aquellos en los que se aislo un Haemophilus mediante cultivo agar chocolate. Las resistencias antibioticas se testaron mediante metodo de difusion disco-placa. De estos pacientes se recogieron los datos de forma transversal y prospectiva durante las visitas en consultas externas. Resultados Se aislo un Haemophilus spp. en 33,6% de los pacientes diagnosticados de uretritis. De estos pacientes, la manifestacion clinica mas frecuente fue la supuracion uretral (57,9%) y el 60% eran hombres que tienen sexo con hombres, siendo el aislamiento de este microorganismo mas frecuente de forma estadisticamente significativa entre los hombres que tienen sexo con hombres que el aislamiento de Neisseria o Chlamydia. Haemophilus spp. se encontro de forma aislada en el 39,5% de los pacientes, siendo el mas frecuente H. parainfluenzae en el 84,2%. El 34,2% de los casos de Haemophilus aislados fueron resistentes a azitromicina y el 26,3% eran resistentes tanto a azitromicina como a tetraciclinas. En los casos en los que no se perdio el seguimiento del paciente (n = 17; 44,7%), el tratamiento administrado de forma empirica consiguio una remision clinica y microbiologica en 11 pacientes, mientras que en 6 fue necesario administrar una pauta de un nuevo antibiotico. Conclusiones Haemophilus es un nuevo agente etiologico de uretritis no gonococicas cuya incidencia esta en aumento, especialmente entre hombres que tienen sexo con hombres que practican sexo oral sin proteccion. Estos pacientes pueden presentar una clinica similar a una uretritis gonococica. Es necesario confirmar la erradicacion debido al elevado numero de resistencias antibioticas testadas en Haemophilus spp.

Introduction: The incidence of urethritis due to Haemophilus species is increasing. The main aim of this study was to describe the clinical and microbiological characteristics of patients with this form of urethritis. A secondary aim was to discuss the adequacy of treatments in patients with different types of antibiotic resistance. Material and methods: We studied patients with a microbiologically confirmed diagnosis of urethritis seen at the Sexually Transmitted Infections Unit of our hospital between July 2015 and July 2018. We selected all patients in whom Haemophilus species were isolated on chocolate agar. Antibiotic resistance was tested using the disk-diffusion method. Cross-sectional data were collected prospectively during outpatient visits. Results: Haemophilus species were isolated in 33.6% of cases. The most common clinical manifestation was urethral discharge (57.6%); 60% of the patients were men who have sex with men and in this subgroup Haemophilus species were significantly more common than either Neisseria or Chlamydia species. Haemophilus species were found in isolation in 39.5% of patients and the most common one was Haemophilus parainfluenzae (isolated in 84.2% of cases). In total, 34.2% of patients were resistant to azithromycin and 26.3% were resistant to both azithromycin and tetracycline. Empirical treatment achieved clinical and microbiologic cure in 11 of the patients who were not lost to follow-up (n = 17; 44.7%). The remaining 6 patients required treatment with a new antibiotic. Conclusions: Haemophilus species are a new cause of nongonococcal urethritis, whose incidence is rising, particularly in men who have sex with men who engage in unprotected oral sex. The clinical manifestations are similar to those seen in gonococcal urethritis. Eradication of infection must be confirmed due to the high rate of antibiotic resistance associated with Haemophilus species. (C) 2018 AEDV. Published by Elsevier Espana, S.L.U. All rights reserved.

Texture feature extraction is an important task in image processing and computer vision. Typical applications include automated inspection, image retrieval or medical analysis. In this paper we propose a noise robust and rotation invariant approach to texture feature analysis and classification. The proposed framework is based on a simple texture feature extraction step which decomposes the image structures by means of a family of orientated filters. The output is an orientation density vector which is called Orientation Feature Vector (OFV). The OFV can be used as the input feature vector to a texture classifier, and in addition, by using an interpolation step it is possible to extract the main orientations of the texture from the OFD, providing additional high level features for image analysis. In this work, three families of filters have been studied in the texture feature extraction step. The experimental results show the ability of the proposed framework in classification problems, improving more than 20% the results of other state-of-the-art methods when a high level of Gaussian noise is considered.

Blood detection in forensic investigation is the milestone in crime scene analysis. Locating bloodstains on dark clothing are often difficult and it is well known the discrepancy about selection of the most suitable method to locate and identify blood stains, depending on the presence of different contaminants and the occurrence of false positives or negatives of human’s blood. The main purpose of this paper was to compare different orientation tests for blood detection on different materials, presenting with contaminated samples and treatments. Human blood was tested in car mat, dark tiles, unlacquered wood surface and sneakers with recent and old stains. Samples were prepared with blood, paint, bleach, dish soap multi-use cleaner, juice, fruit and milk using different combinations and protocols. In the case of forensic lights, and depending on the wavelength and filter used, latent stains were not detected and some false negatives and false positives appeared in different contaminants and treatments. In addition, bleach resulted the main contaminant, altering most tests. In conclusion, our results confirmed that luminol is the most effective test for detecting fresh and latent blood stains, because no type of contamination interfered on its reliability.