Hospital Central de la Cruz Roja San José y Santa Adela

BackgroundCell metabolomics, including lipidomics, presents several challenges regarding analyzing limited cell populations and distinguishing cellular metabolites from background signals originated from a stimuli or after a treatment. To address this, we have developed a novel workflow for untargeted cell lipidomics analysis.MethodsTo study the impact of varying input cell numbers on the outcomes of untargeted cell lipidomics analysis, CD3+ cells isolated from a healthy donor at 6 different cell counts (50k, 100k, 250k, 500k, 750k, and 1M) were analyzed by liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry (LC-QTOF-MS) in positive and negative electrospray ionization (ESI+ and ESI-, respectively) modes. After data quality assurance (QA), Spearman correlation analyses were carried out to select chemical signals derived from cells (ρ ≥ 0.7, p-value < 0.05). Then, this methodology was applied to human microvascular dermal endothelial cells (HMVEC-d), where a cell number calibration curve including 4 cell counts (25k, 50k, 75k, and 100k) was incorporated alongside the experimental samples to enable the analysis of cell-derived chemical signals. Here, the lipid response of HMVEC-d after contact with sera from patients at baseline and during the acute stage of anaphylaxis triggered by three different mechanisms was explored.ResultsFor the CD3+ model, we found that although 1087 chemical signals (k) passed the QA, samples did not cluster according to their cell count when taking all signals into account. After correlation analyses, the widest cell count interval considered for correlation analyses (50k-to-1M; k = 70) showed clear clustering by cell number. The principal component analysis (PCA) models for ESI+ showed that for this cell count interval, the first component explained over 90% of the variance among samples. After applying the same methodology to HMVEC-d, we found k = 157 and k = 278 correlated chemical signals for ESI+ and ESI- in the cell curve (25k-100k). Statistical analysis identified 193 chemical signals that significantly (p-value < 0.05 and p-adjusted value < 0.2) differed between the acute and baseline stages of anaphylaxis. Without this correlation approach, 67 additional chemical signals would have been selected as significant. From the 193 chemical signals, 75 unique lipids were annotated, mainly including fatty acids, acyl carnitines, glycerophospholipids, and sphingolipids, all increased in the acute phase. These changes were associated with sphingolipid and glycosphingolipid metabolism, and ceramide and phospholipid signaling pathways.ConclusionsThis workflow for cell lipidomics analysis allows the selection of lipids derived from the intracellular content regardless external sources, supporting specific intracellular metabolism profiling.

Background: The pathophysiological mechanism of eosinophilic esophagitis (EoE) is complex and is still being investigated. We believe that there is a group of patients with eosinophilic esophagitis which could be differentiated as having an allergic phenotype who exhibit a sensitization profile (aeroallergens, panallergens, foods and specific IgG4 levels) with significant differences compared to patients with conventional allergic disease without associated eosinophilic esophagitis and healthy controls. Method: We measured the prevalence of sensitization to aeroallergens, foods and panallergens by means of molecular diagnostic techniques (ImmunoCAPTM ISAC) and determined the levels of specific IgG4 against foods and eosinophilic-derived neurotoxin (EDN) (ImmunoCAP technology) in patients with EoE of an allergic phenotype to study whether there are statistically significant differences with respect to the control groups (patients with different allergic pathologies without EoE and healthy patients without documented allergies). The total number of patients under study was 118, distributed among the different study groups. The case group (Allergic phenotype EoE patients) had 48 subjects. The food and respiratory allergy control groups had 30 subjects each. Finally, we included 10 in the healthy control group. Results: We were able to identify statistically significant differences when comparing levels of food-specific IgG4. Milk, egg, wheat, nuts, soy, cod, and Pru p3/LTP stood out. We did not observe significant differences in relation to sensitization to aeroallergens, foods, or panallergens. We also did not observe differences in EDN levels. Conclusions: We present a study in which statistically significant differences in IgG4 levels were observed in response to different types of food, comparing patients with eosinophilic esophagitis of allergic phenotype (case group) against subjects with allergic pathology without EoE and healthy subjects (control groups). Determining whether the detected foods are clinically relevant or not in these patients would be fundamental to establishing their usefulness as a treatment alternative in our patients.

One of the objectives proposed by the World Health Organization (WHO) for the period 2022-2030 is to employ new strategies to combat hepatitis. Since universal screening has not been implemented in Spain, opportunistic screenings are being conducted in different healthcare settings. This work analyses the efficiency of this process on the south-eastern region of Spain (Alicante). The efficiency of screening to detect hepatitis C virus (HCV) conducted in emergency, gynecology, surgery, primary care, nephrology, occupational risk accidents, and hematology (opportunist screenings) was compared against the screening conducted in prisons and in vulnerable populations (decentralized screening) using dry blood spot (DBS) testing between 2017 and 2023. The screening cost was calculated applying the Fee Law of the Valencian Community. A total of 66,532 samples were analyzed, out of which viral genome was detected in 315 (0.47%). The prevalence of HCV-positive antibodies in patients from healthcare settings was 0.44%, of which 0.14% had detectable viral RNA (vRNA). In contrast, decentralised screening detected 27.28% positive HCV antibodies and 10.28% viral genomes. In this context, prisons showed a prevalence of positive antibodies and vRNA of 7.39% and 3.30%, respectively. In DBS samples, the prevalence of positive antibodies was 19.89%, with 6.98% showing vRNA. When analyzing the costs of screening processes, the costs of screening patients from gynecology are 89,966 € per patient positive for vRNA, decreasing to 6,744 € in primary care, to 2,983 € in the emergency department, to 518 € in prisons and to 405 € in DBS. Focusing on opportunistic screening, the most cost-effective approach is carried out in the emergency department. Regarding decentralized screening, this study has demonstrated that it is highly effective in our setting, as it targets disadvantaged populations with a high prevalence of infection. Therefore, this screening should be promoted and evaluated to establish its efficacy elsewhere and to advance the detection of patients infected with HCV.

BackgroundBreastfeeding is essential for ensuring the health and survival of children, particularly in regions where diarrhoea, pneumonia and malnutrition are common causes of child mortality. In sub-Saharan Africa, over one million HIV-positive women become pregnant each year and face significant challenges in infant feeding due to limited access to treatment and safe water. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months and continuous breastfeeding up to 24 months in conjunction with antiretroviral treatment. The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of HIV-positive mothers in Africa during the last 10 years, to provide evidence for public health strategies.MethodsA systematic review was conducted on studies that explored the KAP surrounding recommended infant feeding practices among HIV-exposed children in African countries. The review followed the PRISMA guidelines and searched major databases for articles published between 2013 and 2024.ResultsOf the 586 articles identified, 22 met the inclusion criteria. 70% of the studies were conducted in Ethiopia, South Africa, and Kenya and 95% of the studies were carried out in healthcare facilities. Mothers demonstrated good knowledge, attitudes, and practices regarding EBF for HIV-exposed children, but exhibited limited knowledge and negative attitudes towards continuous breastfeeding practice. Healthcare workers were reported as their primary source of information. Stigma associated with practicing EBF and returning to work were identified as major reasons for early cessation of breastfeeding.ConclusionThe knowledge, attitudes, and practices related to the infant feeding practices currently recommended by WHO for HIV-positive mothers were found to be limited. There is little evidence regarding the situation in other countries, particularly among vulnerable women with limited access to the health system. Public health policies must be strengthened to ensure that health workers are adequately trained in the current guidelines in order to improve adherence to infant feeding practices among HIV-positive mothers.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13006-025-00768-8.

IntroductionCongenital umbilical hernia affects 10% of infants. While 80% of cases resolve spontaneously in early childhood, surgical treatment in adults poses challenges due to progressive growth presented over time. Minimally invasive approaches have gained prominence over the past two decades in abdominal wall surgery, with PeTEP (Preperitoneal Enhanced-View Totally Extraperitoneal) being the latest surgical technique introduced. However, its effectiveness in repairing large hernias remains unverified. In this regard, intraoperative fascial traction (IFT) could facilitate fascial closure and potentially expand the indications of this novel surgical technique.Material and MethodsA 29-year-old male with arterial hypertension, a BMI of 29 and no prior surgical history was referred for surgical management of a congenital umbilical hernia. He presented with discomfort at the site of the umbilical hernia, exacerbated by movement. Preoperative CT scan revealed an 8.5 cm × 6 cm hernia defect (large-sized according to EHS guidelines) associated with a 10,1 cm rectus diastasis. Prehabilitation with botulinum toxin (BTA) injection followed by PeTEP surgical repair was performed. IFT was succesfully used to assist in the closure of the hernia defect.ResultsEarly postoperative recovery was favorable, with the patient experiencing low pain levels and being discharged within a day. A 6 cm asymptomatic seroma was observed 1 month postoperatively and was effectively resolved through conservative management. By the 3-month follow-up, the patient reported full functional recovery with no signs of recurrence and satisfactory cosmetic results.ConclusionThis case report demonstrates that the PeTEP approach, complemented by BTA prehabilitation and intraoperative fascial traction, is viable for the repair of larger midline hernias. This combined method may enhance functional outcomes and recovery speed. However, additional research is needed to evaluate its long-term effectiveness.

The predictive coding theory, although a well-supported framework for understanding brain processing, remains elusive regarding how different brain rhythms contribute to error prediction and modify the a priori probabilities of predictive events. This study addresses this issue by analyzing Event-Related Spectral Perturbations (ERSP) generated during an auditory oddball paradigm presented in both a passive and active condition. The design involved sequences of four tones, where the last tone was either predictable (standard, S), completing the scale, or less predictable (deviant, D) when the first tone was occasionally repeated. In the passive condition, participants were instructed to ignore the sounds, whereas, in the active condition, they were asked to press the up or down arrow on a keyboard depending on whether the last tone of the sequence presented a higher or lower frequency than the previous one. This experimental design aimed to bias cognitive processing towards predictable (S) or unpredictable scenarios (D) in two different conditions: passive and attentional. EEG data from 13 channels were analyzed with Morlet wavelets, revealing event-related synchronization (ERS) and desynchronization (ERD) induced by the stimuli. Early theta activity was key in computing prediction errors and updating next-trial expectations. In the active condition, theta responses were higher in D than in S trials, indicating enhanced prediction error processing with attention. Early beta activity also increased during D, likely reflecting motor adjustments. These findings emphasize the critical role of early theta rhythms and the amplifying effect of attention on prediction error processing.