Discovery and validation of serologic biomarkers for the diagnosis and prognosis of invasive candidiasis by computational immunomics

Invasive candidiasis (IC) is an opportunistic systemic mycosis caused by Candida species (commonly Candida albicans) that continues to pose a significant public health problem worldwide. Despite great advances in antifungal therapy and changes in clinical practices, IC remains a major infectious cause of morbidity and mortality in severely immunocompromised or critically ill patients, and further accounts for substantial healthcare costs. Its impact on patient clinical outcome and economic burden could be ameliorated by timely initiation of appropriate antifungal therapy. However, early detection of IC is extremely difficult because of its unspecific clinical signs and symptoms, and the inadequate accuracy and time delay of the currently available diagnostic or risk stratification methods. In consequence, the diagnosis of IC is often attained in advanced stages of infection (leading to delayed therapeutic interventions and ensuing poor clinical outcomes) or, unfortunately, at autopsy. In addition to the difficulties encountered in diagnosing IC at an early stage, the initial therapeutic decision-making process is also hindered by the insufficient accuracy of the currently available tools for predicting clinical outcomes in individual IC patients at presentation. Therefore, it is not surprising that clinicians are generally unable to early detect IC, and identify those IC patients who are most likely to suffer fatal clinical outcomes and may benefit from more personalized therapeutic strategies at presentation. Better diagnostic and prognostic biomarkers for IC are thus needed to improve the clinical management of this life-threatening and costly opportunistic fungal infection...

Valoración del dolor en el paciente con trauma grave y ventilación mecánica no comunicativo

Pain is defined since 1979 by the International Association for the Study of Pain (IASP) as "unpleasant subjective, sensory and emotional experience associated with actual or potential damage of tissue", with the concept more acceptable in our days. The Intensive Care Unit (ICU) is a complex environment to assess pain, where the difficulty in communication with the patient is the biggest barrier to getting your "selfreport", which is considered the gold standard in pain assessment. Many factors alter communication with critically ill patients, as the low level of consciousness, mechanical ventilation, sedation, and the patient's own pathology, besides, there are other limitations such as excessive technology or devices that can divert professional attention to the patient's pain behavior, and lack of training and guidance for management. The multicenter study SUPPORT, it showed that 50-65% of critical patients included suffered pain, and 15% of them reported moderate to severe intensity for more than half the period of hospitalization. Critically ill patients experience pain due to high volume of potentially painful techniques applied to them during their ICU admission, emphasizing nursing care and tracheal suctioning, mobilization, wound healing and channeling of catheters and others. The underestimation of pain involves physiological and hemodynamic effects such as increased blood pressure and/or heart rate, altered breathing pattern, and psychological and anxiety. Also an increase of sedation and mechanical ventilation time and ICU stay of increasing the morbidity and mortality of critically ill patients...

A novel antigen capture ELISA for the specific detection of IgG antibodies to elephant endotheliotropic herpes virus

BACKGROUND Elephants are classified as critically endangered animals by the International Union for Conservation of Species (IUCN). Elephant endotheliotropic herpesvirus (EEHV) poses a large threat to breeding programs of captive Asian elephants by causing fatal haemorrhagic disease. EEHV infection is detected by PCR in samples from both clinically ill and asymptomatic elephants with an active infection, whereas latent carriers can be distinguished exclusively via serological assays. To date, identification of latent carriers has been challenging, since there are no serological assays capable of detecting seropositive elephants. RESULTS Here we describe a novel ELISA that specifically detects EEHV antibodies circulating in Asian elephant plasma/serum. Approximately 80 % of PCR positive elephants display EEHV-specific antibodies. Monitoring three Asian elephant herds from European zoos revealed that the serostatus of elephants within a herd varied from non-detectable to high titers. The antibody titers showed typical herpes-like rise-and-fall patterns in time which occur in all seropositive animals in the herd more or less simultaneously. CONCLUSIONS This study shows that the developed ELISA is suitable to detect antibodies specific to EEHV. It allows study of EEHV seroprevalence in Asian elephants. Results confirm that EEHV prevalence among Asian elephants (whether captive-born or wild-caught) is high.