Crimean-Congo haemorrhagic fever (CCHF) is a widespread tick-borne viral disease caused by the Crimean-Congo haemorrhagic fever virus (CCHFV). CCHFV has been implicated in severe viral haemorrhagic ...fever outbreaks. During the summer of 2016, the first two cases with genotype III (Africa 3) were reported in Spain. The first objective of our study was to determine the presence of CCHFV among patients with febrile illness during the spring and summer periods in 2017 and 2018. Finally, we perform a phylogenetic analysis to determine the genotype of the virus.
We prospectively evaluated patients aged 18 years and older who came to the emergency department at the Salamanca's University Hospital (HUS) with fever. Specific IgM and IgG antibodies against CCHFV by ELISA and one immunofluorescence assay against two different proteins (nucleoprotein and glycoprotein C) was done. Moreover, molecular detection by Real Time PCR was performed in all collected samples. A phylogenetic analysis was carried out to genetically characterize CCHFV detected in this study.
A total of 133 patients were selected. The mean age was 67.63 years and 60.9% were male. One-third of the patients presented an acute undifferentiated febrile illness. Three patients had anti-CCHFV IgG antibodies, suggesting a previous infection. One patient had anti-CCHFV IgM antibodies and a confirmatory RT-PCR. Phylogenetic analysis indicated that the virus corresponds to the European genotype V. This patient came to the emergency department at HUS in August 2018 presenting an acute febrile syndrome with thrombopenia and liver impairment.
We describe a new circulation of European genotype V CCHFV in Spain. Moreover, this study suggests that CCHFV is an identifiable cause of febrile illness of unknown origin in Spain. Thus, CCHF could be suspected in patients with fever, liver damage, and/or haemorrhagic disorders, particularly in people with risk activities who present in the spring or summer.
Babesiosis is a zoonosis caused by an intraerythrocytic protozoan of the genus Babesia and transmitted mainly by ticks of the Ixodes spp. complex. There is no comprehensive global incidence in the ...literature, although the United States, Europe and Asia are considered to be endemic areas. In Europe, the percentage of ticks infected with Babesia spp. ranges from 0.78% to 51.78%. The incidence of babesiosis in hospitalized patients in Spain is 2.35 cases per 10,000,000 inhabitants/year. The mortality rate is estimated to be approximately 9% in hospitalized patients but can reach 20% if the disease is transmitted by transfusion.
To analyze the epidemiological impact of inpatients diagnosed with babesiosis on the National Health System (NHS) of Spain between 1997 and 2019.
A retrospective longitudinal descriptive study that included inpatients diagnosed with babesiosis ICD-9-CM code 088.82, ICD-10 code B60.0, cases ap2016-2019 in public Spanish NHS hospitals between 1 January 1997 and 31 December 2019 was developed. Data were obtained from the minimum basic dataset (CMBD in Spanish), which was provided by the Ministerio de Sanidad, Servicios Sociales e Igualdad after the receipt of a duly substantiated request and the signing of a confidentiality agreement.
Twenty-nine inpatients diagnosed with babesiosis were identified in Spain between 1997 and 2019 (IR: 0.28 cases/10,000,000 person-years). A total of 82.8% of the cases were men from urban areas who were approximately 46 years old. The rate of primary diagnoses was 55.2% and the number of readmissions was 79.3%. The mean hospital stay was 20.3±19.2 days, with an estimated cost of €186,925.66. Two patients, both with secondary diagnoses of babesiosis, died in our study.
Human babesiosis is still a rare zoonosis in Spain, with an incidence rate that has been increasing over the years. Most cases occurred in middle-aged men from urban areas between summer and autumn. The Castilla-La-Mancha and Extremadura regions recorded the highest number of cases. Given the low rate of primary diagnoses (55.2%) and the high number of readmissions (79.3%), a low clinical suspicion is likely. There was a 6.9% mortality in our study. Both patients who died were patients with secondary diagnoses of the disease.
Clinical Spectrum of Schistosomiasis: An Update Carbonell, Cristina; Rodríguez-Alonso, Beatriz; López-Bernús, Amparo ...
Journal of clinical medicine,
11/2021, Letnik:
10, Številka:
23
Journal Article
Recenzirano
Odprti dostop
Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, ...particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated that at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
Low‐count monoclonal B‐cell lymphocytosis (MBLlo) has been associated with an underlying immunodeficiency and has recently emerged as a new risk factor for severe COVID‐19. Here, we investigated the ...kinetics of immune cell and antibody responses in blood during COVID‐19 of MBLlo versus non‐MBL patients. For this study, we analyzed the kinetics of immune cells in blood of 336 COVID‐19 patients (74 MBLlo and 262 non‐MBL), who had not been vaccinated against SARS‐CoV‐2, over a period of 43 weeks since the onset of infection, using high‐sensitivity flow cytometry. Plasma levels of anti‐SARS‐CoV‐2 antibodies were measured in parallel by ELISA. Overall, early after the onset of symptoms, MBLlo COVID‐19 patients showed increased neutrophil, monocyte, and particularly, plasma cell (PC) counts, whereas eosinophil, dendritic cell, basophil, and lymphocyte counts were markedly decreased in blood of a variable percentage of samples, and with a tendency toward normal levels from week +5 of infection onward. Compared with non‐MBL patients, MBLlo COVID‐19 patients presented higher neutrophil counts, together with decreased pre‐GC B‐cell, dendritic cell, and innate‐like T‐cell counts. Higher PC levels, together with a delayed PC peak and greater plasma levels of anti‐SARS‐CoV‐2‐specific antibodies (at week +2 to week +4) were also observed in MBLlo patients. In summary, MBLlo COVID‐19 patients share immune profiles previously described for patients with severe SARS‐CoV‐2 infection, associated with a delayed but more pronounced PC and antibody humoral response once compared with non‐MBL patients.
Cystic echinococcosis (CE) is a chronic, complex and neglected zoonotic disease. CE occurs worldwide. In humans, it may result in a wide spectrum of clinical manifestations, ranging from asymptomatic ...infection to fatal disease. Clinical management procedures have evolved over decades without adequate evaluation. Despite advances in surgical techniques and the use of chemotherapy, recurrence remains one of the major problems in the management of hydatid disease. The aim of this study was to determine the frequency of CE recurrence and the risk factors involved in recurrence.
A descriptive longitudinal-retrospective study was designed. We reviewed all patients diagnosed with CE according to ICD-9 (code 122-0 to 122-9) criteria admitted at Complejo Asistencial Universitario de Salamanca, Spain, between January 1998 and December 2015.
Among the 217 patients studied, 25 (11.5%) had a hydatid recurrence after curative intention treatment. Median duration of recurrence's diagnosis was 12.35 years (SD: ±9.31). The likelihood of recurrence was higher OR = 2.7; 95% CI, 1.1-7.1; p < 0.05 when the cyst was located in organs other than liver and lung, 22.6% (7/31) vs 14.2% (31/217) in the cohort. We detected a chance of recurrence OR = 2.3; 95% CI, 1.4-6.5; p > 0.05 that was two times higher in those patients treated with a combination of antihelminthic treatments and surgical intervention (20/141, 14.2%) than in patients treated with surgical intervention alone (5/76, 6.6%).
Despite advances in diagnosis and therapeutic techniques in hydatid disease, recurrence remains one of the major problems in the management of hydatid disease. The current management and treatment of recurrences is still largely based on expert opinion and moderate-to-poor quality of evidence. Consequently, large prospective and multicenter studies will be needed to provide definitive recommendations for its clinical management.
Detection of SARS-CoV-2 is routinely performed in naso/oropharyngeal swabs samples from patients via RT-qPCR. The RT-LAMP technology has also been used for viral RNA detection in respiratory ...specimens with both high sensitivity and specificity. Recently, we developed a novel RT-LAMP test for SARS-CoV-2 RNA detection in nasopharyngeal swab specimens (named, N15-RT-LAMP) that can be performed as a single-tube colorimetric method, in a real-time platform, and as dry-LAMP. To date, there has been very little success in detecting SARS-CoV-2 RNA in urine by RT-qPCR, and the information regarding urine viral excretion is still scarce and not comprehensive. Here, we tested our N15-RT-LAMP on the urine of 300 patients admitted to the Hospital of Salamanca, Spain with clinical suspicion of COVID-19, who had a nasopharyngeal swab RT-qPCR-positive (
= 100), negative (
= 100), and positive with disease recovery (
= 100) result. The positive group was also tested by RT-qPCR for comparison to N15-RT-LAMP. Only a 4% positivity rate was found in the positive group via colorimetric N15-RT-LAMP and 2% via RT-qPCR. Our results are consistent with those obtained in other studies that the presence of SARS-CoV-2 RNA in urine is a very rare finding. The absence of SARS-CoV-2 RNA in urine in the recovered patients might suggest that the urinary route is very rarely used for viral particle clearance.
(1) Background: Aspergillus produces high morbidity and mortality, especially in at-risk populations. In Spain, the evolution of mortality in recent years due to this fungus is not well established. ...The aim of this study was to estimate the case fatality rate of aspergillosis in inpatients from 1997 to 2017 in Spain. (2) Methodology: A retrospective descriptive study was conducted with records of inpatients admitted to the National Health System with a diagnosis of aspergillosis. (3) Principal findings: Of 32,960 aspergillosis inpatients, 24.5% of deaths were registered, and 71% of the patients who died were men. The percentage of deaths increased progressively with age. The case fatality rate progressively decreased over the period, from 25.4 and 27.8% in 1997–1998 to values of 20.6 and 20.8% in 2016 and 2017. Influenza and pneumonia occurrence/association significantly increased case fatality rates in all cases. (4) Conclusions: Our study shows that lethality significantly decreased in the last two decades despite the increase in cases. This highlights the fact that patients with solid and/or hematological cancer do not have a much higher mortality rate than the group of patients with pneumonia or influenza alone, these two factors being the ones that cause the highest CFRs. We also need studies that analyze the causes of mortality to decrease it and studies that evaluate the impact of COVID-19.
Introducción: Las enfermedades infecciosas son una de las principales causas de morbimortalidad. Por ello, la Universidad Española ha incrementado y complementado la formación postgrado con una ...oferta de Títulos Propios y Másteres Oficiales que buscan la especialización y actualización más avanzada, ya sea profesional o investigadora, en esta área de conocimiento.
Objetivo: Conocer y evaluar la oferta actual de másteres relacionados con las enfermedades infecciosas en las universidades españolas.
Métodos: Revisión bibliográfica realizada en los meses de febrero-marzo 2022 para recoger información sobre estudios de Postgrado, específicamente estudios de Máster Oficial, en el área de Ciencias de la Salud en las Universidades españolas.
Resultados: Desde 2005 en que se instauró el “Máster Universitario en Enfermedades Parasitarias Tropicales”, hasta 2022, se han implantado 11 estudios de postgrado relacionados con las enfermedades infecciosas en 10 universidades españolas. La mayoría tienen una duración de un año y una carga docente media de 70,91±20,23 créditos-ECTS. Número medio de alumnos: 26,27±5,98. Precio medio: 3.095,8±2.479,4€. Existen actualmente másteres en 8 comunidades autónomas y los formatos no presenciales van adquiriendo notoriedad.
Conclusiones: El crecimiento exponencial del número de másteres en España en los últimos años, demuestra el interés creciente y las necesidades de actualización en esta área de conocimiento. Aunque la oferta es extensa, no es homogénea ni equilibrada, presentando áreas potenciales de mejora significativa. Organismos sanitarios y sociedades científicas deberían fomentar la relación entre los diferentes estamentos de la formación de postgrado.
Eur J Clin Invest 2010; 41 (1): 59–69
Background The use of noninvasive positive pressure ventilation (NPPV) outside the intensive wards has been evaluated in patients with no limitation on ...life‐sustaining support. Our aim was to evaluate its usefulness in general wards for patients with NPPV as the ceiling of ventilator care when admission to the intensive care unit (ICU) has been withheld.
Materials and methods Noninvasive positive pressure ventilation was used in 44 patients with acute respiratory failure (ARF) and limitations to respiratory care– 22 with chronic obstructive pulmonary disease (COPD) exacerbations and 22 with acute cardiogenic pulmonary oedema (CPE). Survival at hospital discharge, and survival and readmission rate at 12 months were assessed.
Results Sixty‐three per cent of COPD and 55% of CPE patients survived hospital discharge; and 50% and 37% respectively, were alive after 1 year. The cause of the in‐hospital mortality was related to the admission diagnosis in 88% of cases. Cancer in COPD patients P = 0·040, odds ratio (OR) = 15, 95% CI = 1·14–198 and the completion of NPPV treatment in both diseases (P = 0·008, OR = 0·03, 95% CI = 0·00–0·39 for COPD and P = 0·010, OR = 0·04, 95% CI = 0·00–0·45 for CPE) were related to in‐hospital mortality.
Fifty‐six per cent of COPD and 33% of CPE patients that survived hospital admission were readmitted.
Conclusions Our study suggests that the use of NPPV in general wards could be a safe and effective option, as a last choice treatment, in patients with NPPV as the ceiling of ventilator care when admission to ICU has been withheld.
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