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Longitudinal evidence of functional conversion in a silent corticotroph PitNET

Tue, 31 Mar 2026 08:41:55 GMT

Título : Longitudinal evidence of functional conversion in a silent corticotroph PitNET Autor : Rodríguez-Bedoya, M.; Navarro-Calvo, J.; Sottile, J.; Niveiro de Jaime, M.; Torregrosa, ME; Serrano-Gotarredona, J.; Picó, A. Resumen : Silent corticotroph pituitary neuroendocrine tumours lack clinical hypercortisolism but are associated with an increased risk of invasion and recurrence. Functional conversion to Cushing’s disease remains poorly understood. We report a man with a clinically silent corticotroph PitNET who remained non-functioning for eight years before developing hypercortisolism, followed by recurrent and aggressive disease requiring multimodal therapy. Serial pathology revealed phenotypic remodelling from a sparsely granulated corticotroph tumour to later lesions with foci suggestive of denser granulation and increased proliferative activity. Paired RT-qPCR analysis of fresh tissue showed upregulation of POMC and PCSK1, together with increased EGFR and SSTR3/SSTR5, whereas TBX19, GATA2, PCSK2 and AVPR1B were downregulated, and glucocorticoid receptor pathway transcripts (NR3C1, FKBP5) remained relatively preserved. Marked downregulation of CABLES1 accompanied the aggressive stage. These findings support selective activation of ACTH biosynthesis and processing during functional conversion and suggest that aggressive progression may involve partially distinct biological mechanisms.

Transfusion-transmitted arboviruses: Update and systematic review.

Thu, 05 Mar 2026 18:08:04 GMT

Título : Transfusion-transmitted arboviruses: Update and systematic review. Autor : Giménez-Richarte, Ángel; ORTIZ DE SALAZAR MARTÍN, MARIA ISABEL; Giménez-Richarte, Maria Paz; Collado, Miriam; Fernández, Pedro Luis; Clavijo, Carlos; Navarro, Laura; Arbona, Cristina; Marco, Pascual; Ramos Rincón, José Manuel Resumen : Background: The detection of the first cases of transfusion-transmitted West Nile virus in 2002 posed a new challenge for transfusion safety. Institutions like the World Health Organization have stated that blood transfusion centers need to know the epidemiology of the different emerging infectious agents and their impact on blood transfusion. The aim of the study is to review the published cases of arbovirus transmission through transfusion of blood or blood components and to analyze their main clinical and epidemiological characteristics. Material and methods: Systematic literature searches were conducted in MEDLINE, Embase and Scopus. Pairs of review authors selected a variety of scientific publications reporting cases of transfusion-transmitted arboviruses. Main clinical and epidemiological characteristics were reviewed of the cases described. The study protocol was registered in PROSPERO CRD42021270355. Results: A total of 74 cases of transfusion-transmitted infections were identified from 10 arboviruses: West Nile virus (n = 42), dengue virus (n = 18), Zika virus (n = 3), yellow fever vaccine virus (n = 3), tick-borne encephalitis virus (n = 2), Japanese encephalitis virus (n = 2), Powassan virus (n = 1), St. Louis encephalitis virus (n = 1), Ross River virus (n = 1) and Colorado tick fever virus (n = 1). The blood component most commonly involved was red blood cells (N = 35, 47.3%; 95% confidence interval [CI] 35.9% to 58.7%). In 54.1% (N = 40; 95% CI: 42.7%-65.47%) of the cases, the recipient was immunosuppressed. Transmission resulted in death in 18.9% (N = 14; 95% CI: 10.0%-27.8%) of the recipients. In addition, 18 additional arboviruses were identified with a potential threat to transfusion safety. Discussion: In the last 20 years, the number of published cases of transfusion-transmitted arboviruses increased notably, implicating new arboviruses. In addition, a significant number of arboviruses that may pose a threat to transfusion safety were detected. In the coming years, it is expected that transmission of arboviruses will continue to expand globally. It is therefore essential that all responsible agencies prepare for this potential threat to transfusion safety.

Antiviral treatment or mAbs for persistent SARS‐COV‐2 infection in patients with hematologic malignancies: A case series.

Thu, 05 Mar 2026 18:05:20 GMT

Título : Antiviral treatment or mAbs for persistent SARS‐COV‐2 infection in patients with hematologic malignancies: A case series. Autor : Pérez Catalán, Ignacio; Gómez‐Alfaro, Iris; García‐Muñoz, Sergio; ROIG MARTI, CELIA; Rodríguez, Noelia Lozano; Fabra Juana, Sergio; Esteve Gimeno, Maria José; Gascón‐Buj, Adriana; Freiría Alberte, Carmen; Clavel‐Pia, Juana; Torres García, Miguel; REIG-VALERO, ROBERTO; Ferrando‐Piqueres, Raúl; MATEU-CAMPOS, MARIA-LIDON; Usó Blasco, Jorge; Ramos Rincón, José Manuel

Global research on cysticercosis and neurocysticercosis: A bibliometric analysis

Thu, 05 Mar 2026 18:00:05 GMT

Título : Global research on cysticercosis and neurocysticercosis: A bibliometric analysis Autor : González-Alcaide, Gregorio; Sosa, Néstor; Shevy, Laura; Belinchón-Romero, Isabel; Ramos-Rincón, José Manuel Resumen : Cysticercosis is a parasitic infection caused by the larval stage Taenia solium. As a neglected tropical disease that is also difficult to diagnose, cysticercosis constitutes an important public health and research challenge. To characterize the development of research on cysticercosis and neurocysticercosis, considering the level of scientific evidence provided and the contribution of different countries to research, according to their endemic nature and their income level. Methods: Indexed publications on cysticercosis and neurocysticercosis were retrieved from the MEDLINE database, and the evolution of scientific production and the topic areas addressed in the body of research were analyzed. Results: A total of 7,860 papers published between 1928 and 2021 were analyzed. The volume of annual publications increased over time, standing at over 200 documents/year since 2010. Case studies constitute the main study design (27.4% of the documents with available information, n = 2,155), with fewer studies that provide the highest levels of scientific evidence, such as clinical studies (1.9%, n = 149) or systematic reviews (0.8%, n = 63). The most productive journals belong to the Parasitology and Tropical Medicine categories. Although the USA is the most productive country (n = 2,292), countries where Tenia solium is endemic, such as India (n = 1,749), Brazil (n = 941) and Peru (n = 898) also stand out, as does Mexico (n = 1,414). However, other endemic countries in Latin America and sub-Saharan Africa show little participation in the research. The level of international collaboration by country is very uneven, with some countries presenting very low values, such as India (9.9% of documents in international collaboration) or Brazil (18.7%); while there is evidence of intense international collaboration in countries like Peru (91.3%), Tanzania (88.2%) or Kenya (93.1%). Research output has coalesced in three thematic clusters: basic research in animals; parasitism, animal health, and zoonoses; and the diagnosis and therapeutic approach in diseases associated with cysticercosis and neurocysticercosis. Conclusions: The generation of knowledge on cysticercosis presents different features from other areas of research, such as the outstanding contribution of only some endemic countries; and the relevance of comprehensive approaches to research (animal and human health). Studies that provide higher levels of scientific evidence should be promoted, as should research in endemic areas.

Prone Position in COVID-19 Patients With Severe Acute Respiratory Distress Syndrome Receiving Conventional Oxygen Therapy: A Retrospective Study

Thu, 05 Mar 2026 17:54:47 GMT

Título : Prone Position in COVID-19 Patients With Severe Acute Respiratory Distress Syndrome Receiving Conventional Oxygen Therapy: A Retrospective Study Autor : Loureiro-Amigo, Jose; Suárez Carantoña, Cecilia; Oriol, Isabel; Sánchez-Díaz, Cristina; Coloma-Conde, Ana; Manzano Espinosa, Luis; Rubio-Rivas, Manuel; Otero-Perpiñá, Barbara; Ferreiro-Mazon Jenaro, María Mercedes; Coduras-Erdozain, Ainara; García-Klepzig, José Luis; Vargas-Parra, Derly; Perqueira-Fontán, Paula M; Fiteni-Mera, Isabel; García-García, Gema María

A snapshot of pneumonia research activity and collaboration patterns (2001–2015): a global bibliometric analysis.

Thu, 05 Mar 2026 09:43:56 GMT

Título : A snapshot of pneumonia research activity and collaboration patterns (2001–2015): a global bibliometric analysis. Autor : Ramos Rincón, José Manuel; Pinargote-Celorio, Héctor; Belinchón , Isabel ; González-Alcaide, Gregorio Resumen : Background: This article describes a bibliometric review of the scientific production, geographical distribution, collaboration, impact, and subject area focus of pneumonia research indexed on the Web of Science over a 15-year period. Methods: We searched the Web of Science database using the Medical Subject Heading (MeSH) of “Pneumonia” from January 1, 2001 to December 31, 2015. The only document types we studied were original articles and reviews, analyzing descriptive indicators by five-year periods and the scientific production by country, adjusting for population, economic, and research-related parameters. Results: A total of 22,694 references were retrieved. The number of publications increased steadily over time, from 981 publications in 2001 to 1977 in 2015 (R2 = 0.956). The most productive country was the USA (38.49%), followed by the UK (7.18%) and Japan (5.46%). Research production from China increased by more than 1000%. By geographical area, North America (42.08%) and Europe (40.79%) were most dominant. Scientific production in low- and middle-income countries more than tripled, although their overall contribution to the field remained limited (< 15%). Overall, 18.8% of papers were the result of an international collaboration, although this proportion was much higher in sub-Saharan Africa (46.08%) and South Asia (23.43%). According to the specific MeSH terms used, articles focused mainly on “Pneumonia, Bacterial” (19.99%), followed by “Pneumonia, Pneumococcal” (7.02%) and “Pneumonia, Ventilator-Associated” (6.79%). Conclusions: Pneumonia research increased steadily over the 15-year study period, with Europe and North America leading scientific production. About a fifth of all papers reflected international collaborations, and these were most evident in papers from sub-Saharan Africa and South Asia.

Capacidad diagnóstica de la ecografía clínica pulmonar en pacientes con COVID-19.

Thu, 05 Mar 2026 09:43:19 GMT

Título : Capacidad diagnóstica de la ecografía clínica pulmonar en pacientes con COVID-19. Autor : Gil-Rodrigo, Adriana; Llorens, Pere; Martínez-Buendía, Carmen; Luque-Hernández, María José; Espinosa, Begoña; Ramos Rincón, José Manuel Resumen : Objetivo. Evaluar el rendimiento diagnóstico de la ecografía clínica pulmonar en pacientes con sospecha de infección respiratoria no crítica por SARS-CoV-2 sin alteraciones evidentes en la radiografía de tórax. Método. Estudio de una serie de casos con análisis transversal que incluyó pacientes con sospecha de infección respiratoria por SARS-CoV-2, sintomatología respiratoria leve-moderada y sin hallazgos patológicos concluyentes en la radiografía torácica, que consultaron en un servicio de urgencias durante marzo y abril de 2020. Se realizó una ecografía clínica pulmonar a todos los participantes como parte de la práctica clínica asistencial. Se compararon los hallazgos ecográficos en función del resultado del test SARS-CoV-2. Resultados. Se estudiaron 58 pacientes [mediana de edad 44,5 (RIC 34-67) años; 42 (72,4%) mujeres], 27 (46,5%) con infección por SARS-CoV2 confirmada. Treinta y tres (56,9%) presentaron hallazgos ecográficos de neumonía intersticial por COVID-19, siendo más frecuente en los casos con COVID-19 confirmada (22,2% vs 100%; p < 0,001). Los hallazgos más frecuentes en los casos con COVID-19 confirmada fueron en áreas posterobasales (regiones R1, R2, L1, L2), en forma de líneas B focalizadas y confluentes (85,2%, 77,8%, 88,9% y 88,9%, respectivamente), con irregularidad pleural asociada (70,4%, 70,4%, 81,5% y 85,2%, respectivamente). El diagnóstico del COVID-19 mediante ecografía pulmonar clínica tuvo una sensibilidad de un 92,6% (IC 95%: 75,7-99,1%), una especificidad de un 85,2% (IC 95%: 66,3-95,8%), un valor predictivo positivo fue de un 75,8% (IC 95%: 59,6-91,9%), un valor predictivo negativo de un 92% (IC 95%: 74,0-99,0%), una razón de verosimilitud positiva de un 6,25 (IC 95%: 6,0-6,5) y una negativa de 0,1 (IC 95%: 0,1-0,1). Conclusiones. El uso de la ecografía clínica pulmonar podría ser de ayuda diagnóstica en pacientes con sospecha de infección respiratoria no crítica por SARS-CoV-2 donde la radiografía de tórax no es diagnóstica.; Objective. To assess the diagnostic yield of point-of-care ultrasound imaging in patients suspected of having noncritical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but no apparent changes on a chest radiograph. Methods. Cross-sectional analysis of a case series including patients coming to an emergency department in March and April 2020 with mild-moderate respiratory symptoms suspected to be caused by SARS-CoV-2. A point-of-care ultrasound examination of the lungs was performed on all participants as part of routine clinical care. Ultrasound findings were compared according to the results of SARS-CoV-2 test results. Results. Fifty-eight patients with a median (interquartile range) age of 44.5 (34–67) years were enrolled; 42 (72.4%) were women. Twenty-seven (46.5%) had confirmed SARS-CoV-2 infection. Ultrasound findings were consistent with interstitial pneumonia due to coronavirus disease 2019 (COVID-19) in 33 (56.9%). Most were in cases with testconfirmed COVID-19 (100% vs 22.2% of cases with no confirmation; P < .001). The most common ultrasound findings in confirmed COVID-19 cases were focal and confluent B-lines in the basal and posterior regions of the lung (R1, 85.2%; R2, 77.8%; L1, 88.9%; and L2, 88.9%) and associated pleural involvement (70.4%, 70.4%, 81.5%, and 85.2%, respectively). The sensitivity of point-of-care ultrasound in the diagnosis of COVID-19 was 92.6% (95% CI, 75.7%–99.1%). Specificity was 85.2% (95% CI, 66.3%–95.8%); positive predictive value, 75.8% (95% CI, 59.6%– 91.9%); negative predictive value, 92% (95% CI, 74.0%–99.0%); and positive and negative likelihood ratios, 6.2 (95% CI, 6.0–6.5) and 0.1 (95% CI, 0.1–0.1), respectively. Conclusion. Point-of-care lung ultrasound could be useful for the diagnosis of noncritical SARS-CoV-2 infection when chest radiographs are inconclusive.

Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain.

Thu, 05 Mar 2026 09:40:12 GMT

Título : Clinical Features and Risk Factors for Mortality Among Long-term Care Facility Residents Hospitalized Due to COVID-19 in Spain. Autor : Ramos Rincón, José Manuel; Bernabeu-Wittel, Máximo; FITENI, ISABEL; López Sampalo , Almudena ; López Ríos, María del Carmen; García Andreu, María del Mar; Mancebo Sevilla , Juan José; Jiménez-Juan, Carlos; Matía-Sanz, Marta; López-Quirantes, Pablo; Rubio-Rivas, Manuel; Paredes Ruiz, Diana; González San Narciso, Candela; González-Vega, Rocío; Sanz-Espinosa, Pablo Resumen : COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. METHODS: This is a cross-sectional analysis within a retrospective cohort of hospitalized patients ≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. RESULTS: Of 6 189 patients ≥75 years, 1 185 (19.1%) were LTCF residents and 4 548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs 82.1 years), mostly female (61.6% vs 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p < .001). Mortality risk factors in LTCF residents were severe functional dependence (adjusted odds ratios [aOR]: 1.79; 95% confidence interval [CI]: 1.13-2.83; p = .012), dyspnea (1.66; 1.16-2.39; p = .004), SatO2 < 94% (1.73; 1.27-2.37; p = .001), temperature ≥ 37.8°C (1.62; 1.11-2.38; p = .013); qSOFA index ≥ 2 (1.62; 1.11-2.38; p = .013), bilateral infiltrates (1.98; 1.24-2.98; p < .001), and high C-reactive protein (1.005; 1.003-1.007; p < .001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR: 0.74, 95%CI: 0.62-0.87; p < .001). CONCLUSION: Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.

Etiological Agents and Predisposing Factors of Superficial Fungal Infections in Northeastern Argentina

Thu, 05 Mar 2026 09:39:16 GMT

Título : Etiological Agents and Predisposing Factors of Superficial Fungal Infections in Northeastern Argentina Autor : Almada, Ana Clara; Mereles-Rodríguez, Beda; CHADE, MIRIAM; Belinchón Romero, Isabel; Deschutter, Enrique Jorge; Ramos Rincón, José Manuel Resumen : Superficial fungal infections (SFIs) account for approximately 2% of outpatient visits. Individual, environmental, and socioeconomic factors may increase susceptibility. The objective was to identify the etiological agents of SFIs and the predisposing factors. A cross-sectional descriptive study was conducted on patients attending the Level I Hospital in Puerto Piray, Misiones Province, Argentina, during a community intervention between 2022 and 2023. Statistical analysis was performed on the studied variables and their association with the identified etiological agents. A total of 138 clinical samples were collected from 107 patients with lesions suggestive of SFIs. Of the samples studied, 37% had an identified etiological agent. The majority were women (65%), those aged over 45 years (29%), and patients with underlying conditions (50%). A lack of access to sewage systems (100%) and potable water (19%) and overcrowding (19%) were observed. Dermatophytes (46%) were the most frequent etiological agents, with Trichophyton tonsurans being the primary species. An association was found between dermatophytosis and male sex (odds ratio [OR]: 4.4), ages 1-14 years (OR: 8.04), and overcrowding (OR: 5.38). In conclusion, the prevalence of SFIs was high in the studied population. The main etiological agents involved were anthropophilic dermatophyte fungi. Socioenvironmental conditions may contribute to the incidence of these pathologies.

Predictors of attrition among adults in a rural HIV clinic in southern Mozambique: 18-year retrospective study.

Thu, 05 Mar 2026 09:38:23 GMT

Título : Predictors of attrition among adults in a rural HIV clinic in southern Mozambique: 18-year retrospective study. Autor : Nacarapa, Edy; Verdu, M. Elisa; Nacarapa, Joana; Macuácua, Artur; Chongo , Bartolomeu ; Osorio, Dulce; Munyangaju, Isabelle; Mugabe, Didier; Paredes, Roger; Chamarro, Ana; Revollo, Boris; Santos, Silvio Alexandre; Simango, Mulassua; Torrús, Diego; Ramos Rincón, José Manuel Resumen : HIV remains a major cause of morbidity and mortality for people living in many low-income countries. With an HIV prevalence of 12.4% among people aged over 15 years, Mozambique was ranked in 2019 as one of eight countries with the highest HIV rates in the world. We analyzed routinely collected data from electronical medical records in HIV-infected patients aged 15 years or older and enrolled at Carmelo Hospital of Chokwe in Chokwe from 2002 to 2019. Attrition was defined as individuals who were either reported dead or lost to follow-up (LTFU) (≥ 90 days since the last clinic visit with missed medical pick-up after 3 days of failed calls). Kaplan–Meier survival curves and Cox regression analyses were used to model the incidence and predictors of time to attrition. From January 2002 to December 2019, 16,321 patients were enrolled on antiretroviral therapy (ART): 59.2% were women, and 37.9% were aged 25–34 years old. At the time of the analysis, 7279 (44.6%) were active and on ART. Overall, the 16,321 adults on ART contributed a total of 72,987 person-years of observation. The overall attrition rate was 9.46 per 100 person-years. Cox regression showed a higher risk of attrition in those following an inpatient regimen (hazard ratio [HR] 3.18, 95% confidence interval [CI] 2.89–3.50; p < 0.001), having CD4 counts under 50 cells/µL (HR 1.91, 95% CI 1.63–2.24, p < 0.001), receiving anti-TB treatment within 90 days of ART initiation (HR 6.53, 95% CI 5.72–7.45; p < 0.001), classified as WHO clinical stage III (HR 3.75, 95% CI 3.21–4.37; p < 0.001), and having Kaposi’s sarcoma (HR 1.99, 95% CI 1.65–2.39, p < 0.001). Kaplan–Meier analysis showed that patients with CD4 counts of less than 50 cells/µL on ART initiation had a 40% lower chance of survival at 18 years. Low CD4 cell counts, ART initiation as an inpatient, WHO clinical stage III, and anti-tuberculosis treatment within 90 days of ART initiation were strongly associated with attrition. Strengthening HIV testing and ART treatment, improving the diagnosis of tuberculosis before ART initiation, and guaranteed psychosocial support systems are the best tools to reduce patient attrition after starting ART.