Summary of Spanish recommendations on intensive care to facilitate organ donation

With the aim of consolidating recommendations about the practice of initiating or continuing intensive care to facilitate organ donation (ICOD), an ad hoc working group was established, comprising 10 intensivists designated by the Spanish Society of Intensive Care and Coronary Units (SEMICYUC) and the Spanish National Transplant Organization (ONT). Consensus was reached in all recommendations through a deliberative process. After a public consultation, the final recommendations were institutionally adopted by SEMICYUC, ONT, and the Transplant Committee of the National Health‐Care System. This article reports on the resulting recommendations on ICOD for patients with a devastating brain injury for whom the decision has been made not to apply any medical or surgical treatment with a curative purpose on the grounds of futility. Emphasis is made on the systematic referral of these patients to donor coordinators, the proper assessment of the likelihood of brain death and medical suitability, and on transparency in communication with the patient′s family. The legal and ethical aspects of ICOD are addressed. ICOD is considered a legitimate practice that offers more patients the opportunity of donating their organs upon their death and helps to increase the availability of organs for transplantation.     

Low Apparent Survival and Heterogeneous Movement Patterns of Invasive Blue Catfish in a Coastal River

Blue Catfish Ictalurus furcatus were purposefully introduced into freshwater tributaries to Chesapeake Bay in the past, and populations have subsequently spread to new areas, negatively impacting native communities and causing concern for resource managers. To aid development of management strategies, we implemented a multiyear (2012–2015) tagging study of invasive Blue Catfish in a 40-km stretch of the Potomac River to estimate survival and assess movement patterns. Blue Catfish (N = 1,237) were captured by electrofishing and double-tagged to allow us to estimate tag retention rates; we used reward tags to increase reporting rates. Recaptured fish (N = 104; 8.4% return rate) were at large for between 2 and 1,208 d. Tag retention rates were 0.88 (SE = 0.045) after 1 year and declined to 0.31 (SE = 0.107) after 2.7 years. The mean minimum distance moved by fish was 24.1 km (range = 0.0–112.6 km). Most (63%) fish displayed downriver movements, but distance moved was unrelated to fish size or days at large. Greater distances were observed among fish that moved downriver (34.4 km) than those that moved upriver (6.7 km). These results suggest high variability in movement behaviors for Blue Catfish inhabiting the tidal Potomac River from freshwater reaches to estuarine habitats. We estimated an annual apparent survival rate of 0.56 (SE = 0.057; Brownie tag-return model) across the study period. This survival rate is lower than survival rates reported from their native range. Long-distance movements of Blue Catfish in the Potomac River indicate that robust, large-scale control measures will be needed to reduce population abundance and minimize negative impacts of this species on native communities.

Received May 2, 2017; accepted September 12, 2017     

Accuracy of the Ultra-Rapid Urease Test for diagnosis of Helicobacter pylori infection

Background

Rapid Urease Test (RUT) is a simple, cheap and relatively fast method for diagnosing Helicobacter pylori infection. It is therefore the preferred method used for patients undergoing gastroscopy. Most kits require 24 h to give results. The new Ultra-Rapid Urease Test (URUT) kit by Biohit® requires less than 1 h.

Cirrhosis and liver transplantation in patients co-infected with HIV and hepatitis B or C: an observational cohort study

This study assessed the likelihood of referral for liver transplantation assessment in a prospective cohort of patients co-infected with HIV and hepatitis B or C with complications of cirrhosis. There were 141 co-infected patients from 11 UK centres with at least one complication of cirrhosis recorded (either decompensation or hepatocellular carcinoma) out of 772 identified with cirrhosis and/or HCC. Only 23 of these 141 (16.3%) were referred for liver transplantation assessment, even though referral is recommended for co-infected patients after the first decompensation episode.     

Identification of Novel HBV/HDV Entry Inhibitors by Pharmacophore- and QSAR-Guided Virtual Screening

The hepatic bile acid transporter Na⁺/taurocholate co-transporting polypeptide (NTCP) was identified in 2012 as the high-affinity hepatic receptor for the hepatitis B and D viruses (HBV/HDV). Since then, this carrier has emerged as promising drug target for HBV/HDV virus entry inhibitors, but the synthetic peptide Hepcludex^® of high molecular weight is the only approved HDV entry inhibitor so far. The present study aimed to identify small molecules as novel NTCP inhibitors with anti-viral activity. A ligand-based bioinformatic approach was used to generate and validate appropriate pharmacophore and QSAR (quantitative structure–activity relationship) models. Half-maximal inhibitory concentrations (IC₅₀) for binding inhibition of the HBV/HDV-derived preS1 peptide (as surrogate parameter for virus binding to NTCP) were determined in NTCP-expressing HEK293 cells for 150 compounds of different chemical classes. IC₅₀ values ranged from 2 µM up to >1000 µM. The generated pharmacophore and QSAR models were used for virtual screening of drug-like chemicals from the ZINC¹⁵ database (~11 million compounds). The 20 best-performing compounds were then experimentally tested for preS1-peptide binding inhibition in NTCP-HEK293 cells. Among them, four compounds were active and revealed experimental IC₅₀ values for preS1-peptide binding inhibition of 9, 19, 20, and 35 µM, which were comparable to the QSAR-based predictions. All these compounds also significantly inhibited in vitro HDV infection of NTCP-HepG2 cells, without showing any cytotoxicity. The best-performing compound in all assays was ZINC000253533654. In conclusion, the present study demonstrates that virtual compound screening based on NTCP-specific pharmacophore and QSAR models can predict novel active hit compounds for the development of HBV/HDV entry inhibitors.     

Social Inequalities in Breakfast Consumption among Adolescents in Spain: The DESKcohort Project

Breakfast has a critical role in energy balance and dietary regulation. Consequently, it is considered an important component of a healthy diet, especially in adolescence, when there are great opportunities to consolidate habits and establish future patterns of healthiness in adulthood. Socioeconomic position (SEP) causes inequalities that are reflected in health behaviors, physical activity, mental health, and diet. Therefore, we conducted a cross-sectional study using data from the 2019–2020 DESKcohort project (Spain) to explore the relationships between breakfast and sociodemographic characteristics, health-related behaviors, and school performance of 7319 adolescents. Our findings showed that the prevalence of skipping breakfast every day was 19.4% in girls and 13.7% in boys and was related to students’ SEP. The risk of skipping breakfast was 30% higher in girls from the most disadvantaged SEP, in comparison to those in the most advanced SEP (prevalence ratio (PR) = 1.30; 95% confidence interval (CI) = 1.11–1.54). Also, boys from the most disadvantaged SEP showed 28% higher risk of skipping breakfast than those in the most advanced SEP (PR = 1.28; 95% CI = 1.04–1.59). In conclusion, future public policies should be adapted considering a SEP and gender perspective to avoid increasing nutritional and health inequalities.