Objectives Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a novel coronavirus that causes COVID-19. This disease is associated with leukocytosis with lymphopenia, neutrophilia, and elevated levels of d-dimer, and C-reactive protein, ferritin, procalcitonin, and lactate dehydrogenase. The aim of this study was to describe the clinical and analytical characteristics of hospitalized patients with SARS-CoV-2 infection and to identify prognostic factors of disease progression. Methods Patients were categorized into two groups based on COVID-19 severity. Study variables included demographic data, medical history, length of hospital stay, course of pneumonia, drug therapy, and analytical parameters. A descriptive and multivariate analysis was performed to identify prognostic factors for disease severity. Results The study population included 197 patients, of whom 127 had mild disease and 70 had severe COVID-19. Statistically significant differences were observed in most analytical parameters. The parameters included in the multivariate analysis were advanced age and elevated levels of leukocytes, CRP, GGT, and PCT at admission as prognostic factors for disease severity. Conclusions The prognostic factors for the severity of SARS-CoV-2 infection identified in this study (age, leukocytes, CRP, GGT, and PCT) will help predict the course of the disease at an early stage.

ResumenObjetivosEl SARS-CoV-2 es un nuevo coronavirus, responsable de la enfermedad COVID-19. Entre las alteraciones de los parámetros de laboratorio se han descrito leucocitosis con linfopenia, neutrofilia y aumento de dímero D, proteína C reactiva, ferritina, procalcitonina y lactato deshidrogenasa. El objetivo de este estudio ha sido describir las características clínicas y los parámetros de laboratorio de pacientes ingresados con infección por SARS-CoV-2 e identificar factores pronósticos de progresión de la enfermedad.MaterialesLos pacientes incluidos en el estudio fueron clasificados en dos grupos en función de la gravedad de la infección. Los variables estudiadas fueron los datos demográficos, antecedentes personales, días de ingreso hospitalario, evolución del cuadro neumónico, tratamiento farmacológico y parámetros analíticos. Se realizó un análisis descriptivo de los datos recogidos, así como un análisis multivariante para identificar factores pronósticos de gravedad de la infección.ResultadosLa población de este estudio incluyó a 197 pacientes, considerándose 127 leves y 70 graves. Se encontraron diferencias estadísticamente significativas entre los dos grupos en la mayoría de los parámetros de laboratorio. El análisis multivariante incluyó como factores pronósticos de gravedad la edad avanzada, niveles elevados de leucocitos y concentraciones aumentadas de proteína C reactiva (PCR), γ-glutamiltransferasa (GGT) y procalcitonina (PCT) en el momento del ingreso hospitalario.ConclusionesLos factores pronósticos de gravedad de la infección por SARS-CoV-2 identificados en este estudio (edad, leucocitos, PCR, GGT y PCT) permiten predecir el curso de la enfermedad en las etapas iniciales.

Conflicto de interés: los autores declaran que no existen conflictos de interés. RESUMENIntroducción: la infección por SARS-CoV-2 ha generado un impacto sin precedentes en la salud pública a nivel mundial. El objetivo de este estudio fue la identificación de factores pronósticos de muerte en pacientes con COVID-19 ingresados en unidades de cuidados intensivos (UCI) para predecir el curso de la infección en las etapas críticas.Métodos: estudio descriptivo en el que se incluyen pacientes con infección por SARS-CoV-2 ingresados en la UCI de un hospital de área (Sevilla, España) entre el 25 de agosto de 2020 y el 21 de mayo de 2021.Los pacientes fueron clasificados en recuperados y fallecidos, en función del desenlace de su estancia en UCI. Se realizó un análisis multivariante para conocer los factores pronósticos de muerte.Resultados: la población de este estudio incluyó a 164 pacientes, con una mediana de edad de 71 años, siendo la tasa de mortalidad del 65,9 %. Se encontraron diferencias estadísticamente significativas entre los dos grupos en la edad y algunos parámetros de laboratorio (leucocitos, neutrófilos, hematíes, urea y potasio) en el momento del ingreso en UCI.Los parámetros con mayor asociación a la muerte de los pacientes fueron una edad superior a 63 años, neutrófilos > 10,2 × 10 9 /L, urea > 7,2 mmol/L y hematíes ≤ 4,7 × 10 12 /L.Conclusiones: los factores pronósticos de muerte en pacientes con COVID-19 ingresados en UCI identificados en este estudio (edad, neutrófilos, urea y hematíes) pueden ser empleados para predecir el curso de la infección en las etapas críticas, permitiendo a los clínicos adelantarse al posible desenlace de la enfermedad.

Objective: To identify extremely premature infants (< 31 weeks of gestation and/or < 1,500 grams) affected by congenital hypothyroidism (CH) with delayed elevation of thyrotropin (TSH) and to evaluate the detection strategy for this pathology in our reference screening population. Study Design: A descriptive and retrospective study was carried out with samples collected from western Andalusia and the autonomous city of Ceuta. Results: This protocol allowed us to detect six neonates with delayed TSH elevation. One of them, due to serious heart problems, died without being able to confirm CH. In two neonates, however, it was possible to detect CH, another two presented a persistent TSH elevation but normal free T4, and another one presented a temporary TSH elevation. Conclusion: It is essential to repeat the CH screening in extremely premature infants; not only at the age of 15 days, but also with a third sample at the moment of hospital discharge to detect cases with delayed TSH elevation.

Trichomoniasis, a disease caused by Trichomonas vaginalis, is the most common non-viral sexually transmitted infection worldwide. The importance of its diagnosis lies in its ease of transmission and the absence of symptoms in most cases, as occurs in men, which have a significant role as asymptomatic carriers. The most widely used diagnostic methods are the fresh examination of vaginal or urethral secretions and molecular techniques. However, as they have some disadvantages and, sometimes, low sensitivity, new trichomoniasis diagnostic methods are necessary. Volatile organic compounds in clinical samples are effective in the diagnosis of different diseases. This work aimed to study, for the first time, those present in vaginal discharge and urine of patients with Trichomonas vaginalis infection to look for volatile biomarkers. The results showed that volatile compounds such as 2-methyl-1-propanol and cyclohexanone could serve as biomarkers in vaginal discharge samples, as well as 2-octen-1-ol and 3-nonanone in urine. Moreover, 3-hydroxy-2,4,4-trimethylpentyl 2-methylpropanoate found in vaginal discharge, highly correlated to positive patients, is also highly related to urines of patients with trichomoniasis. The biomarkers described in this study might be a promising diagnostic tool. Key Points • The incidence of Trichomonas vaginalis infection is increasing • Trichomonas vaginalis VOC study in vaginal discharge and urine was performed • The identification of volatile biomarkers could allow a new diagnostic method

Strongyloidiasis is a parasitic disease, very rare in countries like Spain, caused by the Strongyloides stercoralis nematode. We present a case of a 5-year-old patient from Ecuador who came to the Emergency Department due to fever, colicky abdominal pain, watery diarrhea, and occasional vomiting of several days of evolution. In laboratory studies, a marked leukocytosis with eosinophilia stands out, for which reason a microscopic study of the stool was carried out where larval forms compatible with Strongyloides stercoralis were observed. The diagnostic strategy of parasitic infection in developed countries is highly influenced by the low prevalence and diversity of the parasitic species, causing the diagnosis, on many occasions, to be a challenge. In the presence of eosinophilia and abdominal symptoms, it is recommended to orient the diagnosis towards a possible infection of parasitic origin to make an early diagnosis of the infection and avoid possible serious complications.

Metabolites produced by an altered gut microbiota might mediate the effects in the brain. Among metabolites, the fecal volatile organic compounds (VOCs) are considered to be potential biomarkers. In this study, we examined both the VOCs and bacterial taxa in the feces from healthy subjects and Alzheimer’s disease (AD) patients at early and middle stages. Remarkably, 29 fecal VOCs and 13 bacterial genera were differentiated from the healthy subjects and the AD patients. In general, higher amounts of acids and esters were found in in the feces of the AD patients and terpenes, sulfur compounds and aldehydes in the healthy subjects. At the early stage of AD, the most relevant VOCs with a higher abundance were short-chain fatty acids and their producing bacteria, Faecalibacterium and Lachnoclostridium. Coinciding with the development of dementia in the AD patients, parallel rises of heptanoic acid and Peptococcus were observed. At a more advanced stage of AD, the microbiota and volatiles shifted towards a profile in the feces with increases in hexanoic acid, Ruminococcus and Blautia. The most remarkable VOCs that were associated with the healthy subjects were 4-ethyl-phenol and dodecanol, together with their possible producers Clostridium and Coprococcus. Our results revealed a VOCs and microbiota crosstalk in AD development and their profiles in the feces were specific depending on the stage of AD. Additionally, some of the most significant fecal VOCs identified in our study could be used as potential biomarkers for the initiation and progression of AD.

La meningitis bacteriana es una patología grave que requiere de un diagnóstico preciso y precoz. El aumento de leucocitos, con predominio de polimorfonucleares, la proteinorraquia y la hipoglucorraquia orientan hacía una etiología bacteriana, aunque no siempre se correlacionan con el diagnóstico definitivo. El objetivo de este estudio fue evaluar la utilidad del lactato en líquido cefalorraquídeo como biomarcador de meningitis bacteriana. Este es un estudio observacional y prospectivo en el que se analizaron 706 líquidos cefalorraquídeos de pacientes atendidos en el Hospital Universitario Virgen de Valme (Sevilla, España) durante 20 meses. De los líquidos analizados, en 21 casos se diagnosticó meningitis bacteriana, en 31 la meningitis bacteriana fue compatible y en 654 casos se descartó esta infección. El punto de corte óptimo del lactato en líquido cefalorraquídeo fue de 3,0 mmol/L, con una sensibilidad de 68%, una especificidad de 98%, un valor predictivo positivo de 79% y un valor predictivo negativo de 97%. La concentración de lactato, la concentración de proteínas y el número de leucocitos en líquido cefalorraquídeo fue significativamente mayor en los pacientes con meningitis bacteriana confirmada. El alto valor predictivo negativo del lactato es especialmente útil para descartar meningitis bacteriana en pacientes enfermos. El lactato es el biomarcador con mejor rendimiento diagnóstico de todos los analizados, por lo que recomendamos su inclusión en el perfil bioquímico del líquido cefalorraquídeo.