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.

Judgmental-analytical procedures for adapting tests: Adaptation to Spanish of the Reasoning Tests Battery

Adapting a test between cultures or languages requires taking into account legal, linguistic, metric, and use-related considerations. Significantly more attention has been paid to the methodological aspects involved in the study of metric equivalence than to judgmental-analytical procedures prior to the empirical confirmation stage. However, considering the latter is crucial in the adaptation process. Along these lines, this paper seeks to describe and focus on the relevance of the previous stages, thereby offering a systematization process that comprises ten sections. This approach contributes to ensuring the construction of a test adapted and equivalent in as much as possible to the original. This process is exemplified by means of a Spanish language adaptation of a cognitive test originally designed in Portuguese for the Portuguese population, the Reasoning Test Battery. Copyright (C) 2013, Konrad Lorenz University Foundation. Published by Elsevier Espana, S.L.U.

Improved Mechanical Properties of Compatibilized Polypropylene/Polyamide-12 Blends

Compatibilized blends of polypropylene (PP) and polyamide-12 (PA12) as a second component were obtained by direct injection molding having first added 20% maleic anhydride-modified copolymer (PP-g-MA) to the PP, which produced partially grafted PP (gPP). A nucleating effect of the PA12 took place on the cooling crystallization of the gPP, and a second crystallization peak of the gPP appeared in the PA12-rich blends, indicating changes in the crystalline morphology. There was a slight drop in the PA12 crystallinity of the compatible blends, whereas the crystallinity of the gPP increased significantly in the PA12-rich blends. The overall reduction in the dispersed phase particle size together with the clear increase in ductility when gPP was used instead of PP proved that compatibilization occurred. Young's modulus of the blends showed synergistic behavior. This is proposed to be both due to a change in the crystalline morphology of the blends on the one hand and, on the other, in the PA12-rich blends, to the clear increase in the crystallinity of the gPP phase, which may, in turn, have been responsible for the increase in its continuity and its contribution to the modulus.