Clinical factors associated with a Candida albicans Germ Tube Antibody positive test in Intensive Care Unit patients

Background: Poor outcomes of invasive candidiasis (IC) are associated with the difficulty in establishing the microbiological diagnosis at an early stage. New scores and laboratory tests have been developed in order to make an early therapeutic intervention in an attempt to reduce the high mortality associated with invasive fungal infections. Candida albicans IFA IgG has been recently commercialized for germ tube antibody detection (CAGTA). This test provides a rapid and simple diagnosis of IC (84.4% sensitivity and 94.7% specificity). The aim of this study is to identify the patients who could be benefited by the use of CAGTA test in critical care setting. Methods: A prospective, cohort, observational multicentre study was carried out in six medical/surgical Intensive care units (ICU) of tertiary-care Spanish hospitals. Candida albicans Germ Tube Antibody test was performed twice a week if predetermined risk factors were present, and serologically demonstrated candidiasis was considered if the testing serum dilution was >= 1: 160 in at least one sample and no other microbiological evidence of invasive candidiasis was found. Results: Fifty-three critically ill non-neutropenic patients (37.7% post surgery) were included. Twenty-two patients (41.5%) had CAGTA-positive results, none of them with positive blood culture for Candida. Neither corrected colonization index nor antifungal treatment had influence on CAGTA results. This finding could corroborate that the CAGTA may be an important biomarker to distinguish between colonization and infection in these patients. The presence of acute renal failure at the beginning of the study was more frequent in CAGTA-negative patients. Previous surgery was statistically more frequent in CAGTA-positive patients. Conclusions: This study identified previous surgery as the principal clinical factor associated with CAGTA-positive results and emphasises the utility of this promising technique, which was not influenced by high Candida colonization or antifungal treatment. Our results suggest that detection of CAGTA may be important for the diagnosis of invasive candidiasis in surgical patients admitted in ICU.

Los glacis de la cuenca de Miranda de Ebro (Burgos): significado climático y evolución geomorfológica

[ES] En este trabajo se analizan los glacis de la Cuenca de Miranda, en la que constituyen una de las morfologías de mayor relevancia paisajística. Se han establecido dos niveles de glacis cuyas características topográficas, morfológicas y sedimentológicas se integran plenamente dentro de los rasgos propios de estas morfologías. El significado ambiental de estas formaciones y su correlación con los depósitos aluviales del Ebro, han permitido establecer un marco cronológico para ambos niveles, asociando su génesis a los estadios isotópicos 2 y 4, y todo ello dentro de un marco regional coherente.

Evolución de las relaciones transfronterizas en el Bidasoa: de la conurbación a la communauté

[ES] Con la entrada de España en la Unión Europea y la desaparición de la frontera se intensifican las relaciones internacionales. Pero también vecinos que habían permanecido alejados se acercan unos a otros. Los municipios de Bajo Bidasoa, es decir, Irún, Hondarribia y Hendaia, conforman una conurbación y como tal deciden hacer frente a las necesidades de su población. Para ello crean el Consorcio transfronterizo del Bidasoa el año 1998 pero las dificultades que supone trabajar en dos países diferentes limita su desarrollo. Frente a ello surgen nuevas instituciones, de origen comarcal, que comienzan a superar algunas de las barreras con las que se topaba el Consorcio, hasta el punto de poner la continuidad de esta entidad en entredicho.

Multifuncionalidad rural y percepción social en el País Vasco: un reconocimiento pendiente

[ES] Los planes de desarrollo rural del País Vasco se apoyan en gran medida en sus potencialidades naturales, paisajísticas y productivas dirigidas a un urbano que vive en la proximidad. La apreciación de la calidad del entorno rural por parte del ciudadano, por tanto, es fundamental para el progreso de las zonas rurales y supone implícitamente el reconocimiento de la multifuncionalidad de este medio. El urbano, sin embargo, aunque aprecia el entorno natural de los espacios rurales desconoce la función del agricultor en la conservación de este medio siendo la productiva la única aportación que liga a su actividad. El desarrollo rural ha de pasar por el reconocimiento social y para ello es necesario informar y educar al ciudadano.

Luis Badosa: vida y obra. Aproximación a la obra pictórica a través de su vivencia

487 p. : il., col.

Sphingomyelinase D/Ceramide 1-Phosphate in Cell Survival and Inflammation

Sphingolipids are major constituents of biological membranes of eukaryotic cells. Many studies have shown that sphingomyelin (SM) is a major phospholipid in cell bilayers and is mainly localized to the plasma membrane of cells, where it serves both as a building block for cell architecture and as a precursor of bioactive sphingolipids. In particular, upregulation of (C-type) sphingomyelinases will produce ceramide, which regulates many physiological functions including apoptosis, senescence, or cell differentiation. Interestingly, the venom of some arthropodes including spiders of the genus Loxosceles, or the toxins of some bacteria such as Corynebacterium tuberculosis, or Vibrio damsela possess high levels of D-type sphingomyelinase (SMase D). This enzyme catalyzes the hydrolysis of SM to yield ceramide 1-phosphate (C1P), which promotes cell growth and survival and is a potent pro-inflammatory agent in different cell types. In particular, C1P stimulates cytosolic phospholipase A2 leading to arachidonic acid release and the subsequent formation of eicosanoids, actions that are all associated to the promotion of inflammation. In addition, C1P potently stimulates macrophage migration, which has also been associated to inflammatory responses. Interestingly, this action required the interaction of C1P with a specific plasma membrane receptor, whereas accumulation of intracellular C1P failed to stimulate chemotaxis. The C1P receptor is coupled to Gi proteins and activates of the PI3K/Akt and MEK/ERK1-2 pathways upon ligation with C1P. The proposed review will address novel aspects on the control of inflammatory responses by C1P and will highlight the molecular mechanisms whereby C1P exerts these actions.