Using a top predator as a sentinel for environmental contamination with pathogenic bacteria: the Iberian wolf and leptospires

The Iberian wolf (Canis lupus) is the top predator in the Iberian environments in which it lives, feeding on a wide range of species, thus encountering a wide range of disease agents. Therefore, the wolf can serve as sentinel of environmental contamination with pathogens. We investigated the exposure of free-living wolves to 14 serovars of Leptospira interrogans sensu lato. Kidney samples from 49 wolves collected from 2010-2013 in northwestern Spain were analysed by culture, direct immunofluorescence and polymerase chain reaction. Tissue fluids were analysed for antibodies by a microscopic agglutination test. Ten wolves (observed prevalence: 20%, 95% confidence interval = 11-33%) showed evidence of contact with leptospires, eight through direct detection and nine through serology (7 wolves were positive according to both techniques). Titres below the cut-off level were also detected in seven cases. Serovars confirmed were Canicola (n = 4), Icterohaemorrhagiae (n = 3) and Sejroë, Ballum and Grippotyphosa (n = 1 each), indicating that wolves were infected with serovars for which dogs, rodents and ungulates, are the natural hosts and supporting the utility of the wolf and other large predators as environmental sentinels for pathogens.

Fosfomycin versus meropenem in bacteraemic urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli (FOREST): study protocol for an investigator-driven randomised controlled trial.

INTRODUCTION Finding therapeutic alternatives to carbapenems in infections caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) is imperative. Although fosfomycin was discovered more than 40 years ago, it was not investigated in accordance with current standards and so is not used in clinical practice except in desperate situations. It is one of the so-called neglected antibiotics of high potential interest for the future. METHODS AND ANALYSIS The main objective of this project is to demonstrate the clinical non-inferiority of intravenous fosfomycin with regard to meropenem for treating bacteraemic urinary tract infections (UTI) caused by ESBL-EC. This is a 'real practice' multicentre, open-label, phase III randomised controlled trial, designed to compare the clinical and microbiological efficacy, and safety of intravenous fosfomycin (4 g/6 h) and meropenem (1 g/8 h) as targeted therapy for this infection; a change to oral therapy is permitted after 5 days in both arms, in accordance with predetermined options. The study design follows the latest recommendations for designing trials investigating new options for multidrug-resistant bacteria. Secondary objectives include the study of fosfomycin concentrations in plasma and the impact of both drugs on intestinal colonisation by multidrug-resistant Gram-negative bacilli. ETHICS AND DISSEMINATION Ethical approval was obtained from the Andalusian Coordinating Institutional Review Board (IRB) for Biomedical Research (Referral Ethics Committee), which obtained approval from the local ethics committees at all participating sites in Spain (22 sites). Data will be presented at international conferences and published in peer-reviewed journals. DISCUSSION This project is proposed as an initial step in the investigation of an orphan antimicrobial of low cost with high potential as a therapeutic alternative in common infections such as UTI in selected patients. These results may have a major impact on the use of antibiotics and the development of new projects with this drug, whether as monotherapy or combination therapy. TRIAL REGISTRATION NUMBER NCT02142751. EudraCT no: 2013-002922-21. Protocol V.1.1 dated 14 March 2014.

Evaluation of the efficacy and safety of lanreotide in combination with targeted therapies in patients with neuroendocrine tumours in clinical practice: a retrospective cross-sectional analysis.

BACKGROUND Based on the mechanism of action, combining somatostatin analogues (SSAs) with mTOR inhibitors or antiangiogenic agents may provide synergistic effects for the treatment of patients with neuroendocrine tumours (NETs). Herein, we investigate the use of these treatment combinations in clinical practice. METHODS This retrospective cross-sectional analysis of patients with NETs treated with the SSA lanreotide and targeted therapies at 35 Spanish hospitals evaluated the efficacy and safety of lanreotide treatment combinations in clinical practice. The data of 159 treatment combinations with lanreotide in 133 patients was retrospectively collected. RESULTS Of the 133 patients, with a median age of 59.4 (16-83) years, 70 (52.6 %) patients were male, 64 (48.1 %) had pancreatic NET, 23 (17.3 %) had ECOG PS ≥2, 41 (30.8 %) had functioning tumours, 63 (47.7 %) underwent surgery of the primary tumour, 45 (33.8 %) had received prior chemotherapy, and 115 (86.5 %) had received prior SSAs. 115 patients received 1 lanreotide treatment combination and 18 patients received between 2 and 5 combinations. Lanreotide was mainly administered in combination with everolimus (73 combinations) or sunitinib (61 combinations). The probability of being progression-free was 78.5 % (6 months), 68.6 % (12 months) and 57.0 % (18 months) for patients who only received everolimus plus lanreotide (n = 57) and 89.3 % (6 months), 73.0 % (12 months), and 67.4 % (18 months) for patients who only received sunitinib and lanreotide (n = 50). In patients who only received everolimus plus lanreotide the median time-to-progression from the initiation of lanreotide combination treatment was 25.8 months (95 % CI, 11.3, 40.3) and it had not yet been reached among the subgroup of patients only receiving sunitinib plus lanreotide. The safety profile of the combination treatment was comparable to that of the targeted agent alone. CONCLUSIONS The combination of lanreotide and targeted therapies, mainly everolimus and sunitinib, is widely used in clinical practice without unexpected toxicities and suggests efficacy that should be explored in randomized prospective clinical trials.

Accesibilidad en los espacios públicos urbanizados

El libro, coordinado por el Director de ACCEPLAN, Fernando Alonso López, viene a ser un reflejo de los avances entorno a la búsqueda de accessibilidad universal en los espacios públicos urbanizados. Para aproximarse a la realidad normativa y técnica de la Orden Ministerial el libro se estructura en artículos referentes al contexto normativo, a los contenidos de la Orden, y a reflexiones y criterios en torno a la accesibilidad en la ciudad. Del conjunto de artículos, por su variedad y por su carácter multidiciplinar, se extrae un libro de referencia que ofrece la variedad de enfoques del tema y que ayuda a interpretar mejor la Orden Ministerial, su contribución a los objetivos de la Ley 51/2003 de Igualdad de Oportunidades No Discriminación y Accesibilidad Universal, LIONDAU, y su utilidad en la comformación de unas ciudades cada vez más abiertas a la diversidad funcional y a la convivencia.

A debat : la lectura al segle XXI

La lectura al segle XXI és un tema que per als bibliotecaris inclou molts aspectes apassionants i difícils d'aglutinar en una hora i mitja. En aquesta ocasió, hem volgut parlar no només amb bibliotecaris, sinó també amb altres actors involucrats en aquest sector. El resultat ha estat un debat ric i divers, que ha abastat aspectes com el comportament del lector, l'accés a la informació, els canvis en la lectura, el llibre electrònic o el paper de les institucions i la societat.

Utilidad de la densitometría de doble energía (DEXA) en la valoración de las alteraciones morfológicas y estructurales en el paciente VIH en relación con distintos regímenes de tratamiento antiretroviral (TAR)

Objetivo: Comparar la distribución de la grasa corporal mediante DEXA, en pacientes VIH+ monoinfectados y coinfectados VHC, que reciben tratamiento antirretroviral basado en inhibidores de proteasa o no nucléosidos. Materiales y Métodos: Estudio retrospectivo, observacional, unicéntrico. Resultados: 80 pacientes, 60 hombres, 20 mujeres. 41 monoinfectados, 39 coinfectados. Edad 48 años, peso 71 kg, IMC 24, 39 IP, 41 NN. Los coinfectados tenían triglicéridos, colesterol y LDL-c inferiores a los monoinfectados (p <0.05). La DEXA no mostró diferencias en la comparación de mono/coinfectados y grupos de tratamiento. Conclusiones: No se encontraron diferencias entre grupos. Los coinfectados muestran lípidos plasmáticos inferiores.

M. Fontoura Xavier [i. e Antonio Vicente da Fontoura Xavier] ambassadeur du Brésil à Londres : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 57289

Guidelines for the use and interpretation of assays for monitoring autophagy.

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field.

De viles rurals a indrets de la regió metropolitana de Barcelona: transformacions històriques del paisatge a la Vall del Congost (Figaró-Montmany, l’Ametlla del Vallès i la Garriga, 1850-2010)

El projecte ha assolit la majoria d’objectius, ajustats a la reducció d'una quarta part de l'import concedit: 1) caracteritzar la transformació del paisatge agro-forestal i urbà a dos municipis de la vall del Congost, La Garriga i Figaró-Montmany, reconstruint amb SIG els mapes d'ús del sòl de 1854, 1949, 1956 i 2005, obtenint per intersecció de cobertes les matrius dels canvis d'ús; i 2) avaluar amb l’índex de connectivitat ecològica l'impacte ambiental d'aquells canvis des del punt de vista de la biodiversitat i la resiliència del paisatges, amb un especial èmfasi en la reforestació induïda per l'abandonament rural i la pèrdua de paisatges en mosaic, en un àmbit més gran pel període 1956-1993-2005. Aquests resultats han permès preparar varis articles per publicar en co-autoría a revistes com Landscape History, Environment and History o Landscape and Urban Planning. Ja és a punt de poder-se lliurar el primer amb el títol de "Looking backwards into a Mediterranean edge environment: Landscape changes and ecological connectivity in El Congost Valley (province of Barcelona, Catalonia) 1850-2005", incloent dos objectius esmentats a la memòria: identificar les principals forces motores d'aquells canvis en el paisatge relacionant els usos del sòl amb les formes d'ordenació del territori, caracteritzar-ne les forces rectores econòmico-socials i el paper jugat per la protecció del Parc Natural del Montseny i els Cingles de Bertí. Els resultats també permetran abordar en el futur altres aspectes, com per exemple estimar el potencial energètic de la biomassa local tot cercant que el seu aprofitament generi sinèrgies territorials positives per a l'ecologia del paisatge amb la recuperació d’una ramaderia extensiva i una agricultura ecològica que facin possible la restauració dels paisatges en mosaic. L'estudi ha pogut incorporar un aspecte inicialment no previst, el cens d'orquídies mediterrànies a Figaró-Montmany elaborat pel naturalista Paul Wilcox

Riscos en incendis de vehicles de nova generació

Les actuacions de bombers en operatius d'extinció d'incendis, habitualment es fan per inèrcies històriques. Ara, si diem: “Per a l'extinció d'un incendi de un vehicle heu d'estacionar l’autobomba a una certa distància, pendent amunt i a contravent, refrigerar a distància el vehicle amb con d'atac, i evitar els extrems del vehicle”, segurament més d'un pensarà o expressarà en veu alta “Això deu ser una broma, oi? Si hem estat apagant cotxes cada dia a la nostra manera… quin és el problema?". Bé, doncs n’hi ha uns quants, de problemes. Podem considerar un incendi en un vehicle com una bomba de temps amb un ble que s'encén abans de l'arribada de la dotació de bombers. Les actuacions inicials en aquests incendis han de centrar-se en la desactivació d'aquesta metxa. Els incendis en vehicles presenten una múltiple varietat perills reals. Els canvis en el disseny i la construcció d'automòbils exigeixen un canvi en la manera com els serveis de bombers s’enfronten als incendis de vehicles. Els nous materials i components incorporats a la indústria automobilística s'han traduït en un millor rendiment, una major economia de combustible, una millor resistència al xoc i en una reducció de les emissions de gasos. Malauradament, alguns d'aquests mateixos materials i components fan que l’extinció d’un automòbil modern sigui més difícil i perillosa que en vehicles més vells. En l’actualitat, un incendi d’un vehicle comporta més fums, més toxicitat, més temperatura, elements sotmesos a pressió, risc de projecció d’elements i la possibilitat d’energies alternatives... en definitiva, molts més riscos. Per donar una resposta adequada a aquest augment del risc, organitzativament cal augmentar les mesures preventives de seguretat, i operativament cal una estratègia d’extinció més cautelosa, tàctiques menys agressives i un major nivell de protecció personal.