Hospital Jerez Puerta del Sur

Gastric cancer (GC) remains an oncological challenge, with lymph node involvement being a major prognostic factor. Sentinel lymph node (SLN) mapping may improve staging and reduce morbidity. This study evaluated a dual-tracer technique (superparamagnetic iron oxide: SPIO and methylene blue) for ex vivo detection; assessed one-step nucleic acid amplification (OSNA) versus conventional histology; and applied OSNA-pooling analysis in non-SLN. Prospective study of patients undergoing curative gastrectomy with lymphadenectomy (2017–2022). SLNs were identified in fresh specimens by Sentimag® and/or macroscopic staining. Each lymph node was bisected, with one half analyzed by hematoxylin–eosin (H&E) and the other by OSNA. Non-SLN were assessed using pooled OSNA to enhance diagnostic performance. Diagnostic performance metrics and agreement (Cohen’s κ) were calculated. Survival was estimated by Kaplan–Meier. Thirty-eight patients were included (mean age 64.3 years; 58% male); 71.1% received neoadjuvant therapy. SLN detection rate was 84.2% (32/38), with 80 SLNs identified. The dual-tracer approach demonstrated high sensitivity (93.1%) and moderate specificity (44.4%), resulting in an accuracy of 81.6%. Tracer concordance was moderate (κ = 0.42; p < 0.007). OSNA showed good agreement with H&E (sensitivity 80%, specificity 87%), and better performance for micrometastases. The pooling analysis evaluated 1155 non-SLN simultaneously; this novel strategy showed good concordance with conventional histology. After a median follow-up of 53 months, OSNA and H&E status were associated with overall survival in exploratory analyses; however, these findings should be interpreted with caution given the limited sample size and ex vivo proof-of-concept design. Combining SPIO and methylene blue is technically feasible for ex vivo SLN mapping. OSNA complements histology, and its pooled use represents an innovative methodological approach. These results are preliminary and hypothesis-generating; larger prospective in vivo studies are required before clinical applicability can be evaluated. Dual-tracer sentinel node mapping in gastric cancer proved feasible and accurate. OSNA complemented histology, pooled analysis improved detection efficiency, and neoadjuvant therapy did not affect diagnostic performance.

Exposomic determinants substantially influence the variability of molecular IgE-mediated sensitization in allergic rhinitis and conjunctivitis across bioclimatic regions, underscoring their relevance in precision allergology. This study aimed to characterize molecular sensitization profiles in Spanish patients with respiratory allergy from distinct geographic and climatic areas. A cross-sectional, multicenter study was performed in 12 Spanish cities. The study population comprised 291 patients diagnosed with allergic rhinitis and/or conjunctivitis according to the modified ARIA/DECA criteria. Participants underwent skin prick testing with standardized allergen extracts and multiplex molecular IgE analysis. Clinical, demographic, and regional bioclimatic variables were integrated to define exposomic sensitization patterns. Patients previously treated with allergen immunotherapy or biologics were excluded. Regional pooled sera were analyzed by ELISA and IgE immunoblotting to validate molecular data and identify IgE binding to nonrecombinant or poorly characterized allergenic components. Distinct regional sensitization profiles were identified. Grass pollen allergens predominated in oceanic and continental climates, while olive and cypress pollens were more frequent in Mediterranean areas. Sensitization to house dust mite, particularly Dermatophagoides pteronyssinus and Blomia tropicalis, was highly prevalent in subtropical and humid zones. Molecular assays confirmed skin test findings and identified major allergenic molecules, including Phl p 1, Ole e 1, Der p 1, and Der p 2, along with region-specific components such as Der p 23, Cup a 1, Alt a 1, and Pla a 2. This multicenter exposomic study demonstrated that climatic diversity modulates allergen sensitization in Spain, supporting region-tailored precision diagnostic and therapeutic strategies in respiratory allergy.

This study assessed the clinical burden of carbapenemase-producing Enterobacterales (CPE) infections according to different resistance mechanisms among Enterobacterales isolates in Spain. This retrospective study was conducted in five Spanish hospitals from the National Mapping of Carbapenemases in Spain study. Patients were included if they were 18 years or older; had a diagnosis of complicated intraabdominal infection (cIAI), complicated urinary tract infection (cUTI), bloodstream infection (BSI), or hospital-acquired or ventilator-acquired bacterial pneumonia (HABP/VABP) between 2017 and 2018; and had a confirmed CPE isolate. In total, 118 patients were evaluable for clinical outcomes. The most common mechanism of carbapenem resistance was Klebsiella pneumoniae carbapenemase (KPC; n = 82, 69.5%), followed by OXA-48 (n = 27, 22.9%) and metallo-β-lactamases (MBL; n = 9, 7.6%). Overall, 75 patients (63.6%) died from any cause, including 21 deaths (28.0% of all deaths) attributable to the current infection. Clinical cure was achieved in 92 patients (78.0%) and microbiological cure in 59 (54.6%). Among the 92 patients discharged alive, 29 (31.5%) were readmitted for an infectious disease, and relapse within 30 days occurred in 10 patients (10.9%). Data suggest that CPE infections are associated with a high disease burden, low rates of clinical cure, and high rates of relapse and mortality in Spain. However, results should be interpreted with caution due to the limited sample size which may have restricted the precision of these estimates and gaps in minimal inhibitory concentration data availability.