Suchergebnisse

Los Practicantes de la Armada, desde principios de siglo XX hasta finalizar la guerra civil, en las distintas zonas marítimas de nuestra geografía, fueron protagonistas destacados de la institución colegial. Eran profesionales muy bien formados y con amplias competencias laborales, gran bagaje de vivencias y con un elevado sentido del corporativismo como arma para defender unos derechos que no les eran reconocidos. El objetivo de este estudio consiste en describir la vida de Pedro J. Martínez desde la doble perspectiva de militar y practicante. Para ello, hemos empleado una metodología basada en el proceso heurístico de fuentes primarias de origen archivístico localizadas en el Archivo Central del Cuartel General de la Armada y Archivo del Colegio de Enfermería de Cádiz. También hemos obtenido importante información de la prensa profesional del momento, como es el caso de El Practicante Gaditano y recurrido a la documentación personal con la Catedrática Victoria Fernández Díaz. Toda la documentación obtenida ha sido analizada siguiendo las orientaciones de la disciplina histórica, especialmente la biográfica y de vida. Los resultados obtenidos en esta investigación nos llevan a perfilar a Martínez Moreno como un individuo que, por sus cualidades y conocimientos, destacaba en su actividad profesional y en el ambiente social. Cartagenero de nacimiento y practicante de la Armada, era algo más que un personaje. Desde su tierra natal, donde fue presidente del Colegio Departamental de Cartagena, fundador y propietario de la revista "El Practicante Moderno", hasta llegar a la capital gaditana donde resultó elegido presidente del Colegio de Practicantes de Cádiz. No pasaba nunca desapercibido y destacaba en todos los ámbitos donde residía. También era un profesional militar muy considerado por sus superiores y así le era oficialmente reconocido. En cumplimiento al Decreto del Gobierno provisional de la República de 23 de abril de 1931, prestó la preceptiva promesa de adhesión y fidelidad a la República. Esa lealtad, le costaría salir exiliado al finalizar la guerra civil, y morir años después, en tierra extranjera (Túnez), sin el reconocimiento debido y el mayor de los olvidos. Por tanto, las conclusiones extraídas de nuestro trabajo son que la vida de Pedro José Martínez Moreno se desarrolló de forma especialmente relevante tanto desde la perspectiva militar como sanitaria, dado que los diferentes cargos en las presidencias colegiales denotan unas habilidades sociales y profesionales altamente infrecuentes, del mismo modo que denotan su continuo y profundo compromiso con la profesión de enfermería desde la representatividad colegial. ; The Navy Surgery Practitioners, from the beginning of the twentieth century until the civil war, the different maritime of our geography, they were prominent protagonist of the collegiate institution. They were very well trained professionals with extensive work skills, great baggage of experiences and with a high sense of corporatism as a weapon to defend rights that were not recognized to them. The objective of this study is describing the life of Pedro J. Martínez Moreno from the dual perspective of military and surgery practitioner. To do this, we have used a methodology based on the heuristic process of primary sources of archival origin located in the Central Archive of the Headquarters of the Navy and file of the College of Nursing of Cádiz. We have also obtained important information from the professional press of the moment, as is the El Practicante Gaditano and resorted to personal documentation with Professor Victoria Fernández Díaz. All the documentation obtained has been analyzed according to the orientation of historical discipline, especially biographical and life. The results obtained in this research lead us to profile Martínez Moreno as an individual who, for his qualities and knowledge, he exceled in his professional activity and in the social environment. Cartagenero by birth and navy surgery practitioner, was more than just a character. From his homeland, where he was president of the Departmental College of Cartagena, founder and owner of the professional magazine "El Practicante Moderno", until arriving in the capital of Cádiz where he was elected president of College of Surgery Practitioners of Cádiz. It never went unnoticed and stood out in all areas where he resided. He was also a military professional highly regarded by his superiors and thus was officially recognized. In compliance with the Decree of the Provisional Government of the Republic of 23 April 1931, it provided the mandatory promise of accession and fidelity to the Republic. That loyalty would cost him to go into exile at the end of the civil war, and die years later, in a foreign land (Tunisia), without due recognition and the greatest oblivion. Therefore, the conclusions drawn from our work are that the life of Pedro José Martínez Moreno developed in an especially relevant way from both the military and health perspective, given that the different positions in the collegiate presidencies denote highly infrequent social and professional skills, in the same way that they denote their continuous and deep commitment to the nursing profession from collegiate representation. ; Os Praticantes da Marinha, desde o início do século XX até ao fim da guerra civil, nas diferentes áreas marítimas da nossa geografia, foram protagonistas notáveis da instituição colegial. Eram profissionais muito bem treinados, com vastas competências de trabalho, uma grande experiência e um forte sentido de corporativismo como arma para defender direitos que não eram reconhecidos. O objectivo deste estudo é descrever a vida de Pedro J. Martínez a partir da dupla perspectiva de militar e praticante. Para tal, utilizámos uma metodologia baseada no processo heurístico de fontes primárias de origem arquivística localizadas no Arquivo Central do Quartel-General da Marinha e no Arquivo do Colégio de Enfermagem de Cádis. Obtivemos também informações importantes da imprensa profissional da época, como é o caso de El Practicante Gaditano e recorremos à documentação pessoal com a Professora Victoria Fernández Díaz. Toda a documentação obtida foi analisada seguindo as directrizes da disciplina histórica, especialmente a biografia e a história de vida. Os resultados obtidos nesta investigação levam-nos a traçar o perfil de Martínez Moreno como um indivíduo que, devido às suas qualidades e conhecimentos, se destacou na sua actividade profissional e no meio social. Cartaginês de nascimento e estagiário da Marinha, ele era mais do que uma personagem. Desde a sua pátria, onde foi presidente do Colégio Departamental de Cartagena, fundador e proprietário da revista "El Practicante Moderno", até à capital de Cádis, onde foi eleito presidente do Colégio de Praticantes de Cádis. Ele nunca passou despercebido e destacou-se em todas as áreas onde viveu. Era também um profissional militar altamente considerado pelos seus superiores e foi oficialmente reconhecido como tal. Em conformidade com o Decreto do Governo Provisório da República de 23 de Abril de 1931, fez a promessa obrigatória de adesão e lealdade à República. Esta lealdade custar-lhe-ia ir para o exílio no final da guerra civil, e morrer anos mais tarde, numa terra estrangeira (Tunísia), sem o devido reconhecimento e o maior esquecimento. Portanto, as conclusões retiradas do nosso trabalho são que a vida de Pedro José Martínez Moreno se desenvolveu de uma forma particularmente relevante tanto do ponto de vista militar como do ponto de vista da saúde, uma vez que as diferentes posições nas presidências colegiadas denotam competências sociais e profissionais altamente invulgares, da mesma forma que denotam o seu compromisso contínuo e profundo com a profissão de enfermagem a partir da representatividade colegial.

CD300a receptor is found on different CD8+ T cell subsets and its expression has been associated to a more cytotoxic molecular signature. CD300a has an important role in some viral infections and its expression levels are known to be modulated by human immunodeficiency virus (HIV)−1 infection on several cell types. The main objective of this work was to investigate CD300a expression and its regulation during HIV-1 specific CD8+ T cell responses. CD300a receptor expression was analysed by multiparametric flow cytometry on CD8+ T lymphocytes from HIV negative donors, naive HIV-1+ individuals and HIV-1+ subjects under suppressive combined antiretroviral therapy (cART). HIV-1 specific CD8+ T cell response was studied by stimulating cells with HIV-1 derived peptides or with a Gag HIV-1 peptide. Our results showed that HIV-1 specific CD8+ T cells expressing higher levels of CD300a were more polyfunctional showing an increased degranulation and cytokine production. Moreover, we observed an up-regulation of CD300a expression after Gag HIV-1 peptide stimulation. Finally, our results demonstrated an inverse correlation between CD300a expression on CD8+ T lymphocytes and HIV disease progression markers. In conclusion, CD300a expression is associated to a better and more polyfunctional HIV-1 specific CD8+ T cell response. ; This study was supported by a grant from "Plan Estatal de I+ D+ I 2013–2016, ISCIII-Subdirección de Evaluación y Fomento de la Investigación-Fondo Europeo de Desarrollo Regional (FEDER) (Grant PI13/00889)" and Marie Curie Actions, Career Integration Grant, European Commission (Grant CIG 631674). Joana Vitallé and Iñigo Terrén are recipients of a predoctoral contract funded by the Department of Education, Basque Government (PRE_2017_2_0242 and PRE_2018_1_0032). Joana Vitallé and Iñigo Terrén are recipients of a fellowship from the Jesús de Gangoiti Barrera Foundation (FJGB15/008 and FJGB17/003). Laura Tarancón-Díez was supported by Instituto de Salud Carlos III, PFIS (FI00/00431). Olatz Zenarruzabeitia is recipient of a postdoctoral contract funded by "Instituto de Salud Carlos III-Contratos Sara Borrell 2017 (CD17/0128)" and the European Social Fund (ESF)-The ESF invests in your future. Ezequiel Ruiz-Mateos is supported by Programa Nicolás Monardes, C0032-2017, Consejería de Salud y Bienestar Social, Junta de Andalucía. Francisco Borrego is an Ikerbasque Research Professor, Ikerbasque, Basque Foundation for Science.

The ability of the CD300a inhibitory receptor to modulate immune cell functions and its involvement in the pathogenesis of many diseases has aroused a great interest in this molecule. Within human CD4+ T lymphocytes from healthy donors, the inhibitory receptor CD300a is differentially expressed among different T helper subsets. However, there are no data about the expression and regulation of CD300a receptor on CD4+ T cells from human immunodeficiency virus (HIV)-infected patients. The objective of this study was to investigate the expression of CD300a on CD4+ T cells from HIV-infected patients on suppressive combined antiretroviral therapy (cART) and cART naïve patients. Our results have demonstrated that the expression levels of this inhibitory receptor were higher on CD4+ T cells from HIV infected subjects compared with healthy donors, and that cART did not reverse the altered expression of CD300a receptor in these patients. We have observed an increase of CD300a expression on both PD1+CD4+ and CD38+CD4+ T cells from HIV infected people. Interestingly, a triple positive (CD300a+PD1+CD38+) subset was expanded in naïve HIV infected patients, while it was very rare in healthy donors and patients on cART. Finally, we found a negative correlation of CD300a expression on CD4+ T lymphocytes and some markers associated with HIV disease progression. Thus, our results show that HIV infection has an impact in the regulation of CD300a inhibitory receptor expression levels, and further studies will shed light into the role of this cell surface receptor in the pathogenesis of HIV infection. ; This study was supported by a grant from "Plan Estatal de I + D + I 2013–2016, ISCIII-Subdirección de Evaluación y Fomento de la Investigación-Fondo Europeo de Desarrollo Regional (FEDER) (Grant PI13/00889)" and Marie Curie Actions, Career Integration Grant, European Commission (Grant CIG 631674). JV is recipient of a predoctoral contract funded by the Department of Education, Language Policy and Culture, Basque Government (PRE_2017_2_0242). JV and IT are recipients of a fellowship from the Jesús de Gangoiti Barrera Foundation (FJGB15/008 and FJGB17/003). LT-D was supported by Instituto de Salud Carlos III, PFIS (FI00/00431). OZ is recipient of a postdoctoral contract funded by "Instituto de Salud Carlos III-Contratos Sara Borrell 2017 (CD17/0128)" and the European Social Fund (ESF)-The ESF invests in your future. ER-M is supported by Programa Nicolás Monardes, C0032-2017, Consejería de Salud, Junta de Andalucía. FB is an Ikerbasque Research Professor, Ikerbasque, Basque Foundation for Science. ; Peer Reviewed

PurposeVery scarce information has been published to date with the combination of ABC/3TC/NVP but it is currently being used in clinical practice in Spain and Portugal. Our aim was to present the clinical experience with this regimen in a cohort of adult HIV‐infected antiretroviral (ARV)‐naïve patients.MethodsRetrospective, multicentre, cohort study. Consecutive adult HIV‐infected ARV‐naïve HLA‐B*5701‐negative patients, who started ABC/3TC/NVP between 2005‐2013, with at least one follow‐up visit, were included. Demographic, clinical and laboratory variables were assessed at baseline, month 1, and every three–four months thereafter. The primary end point was HIV‐1 viral load (VL)<40 c/mL at 48 weeks. Data were analyzed by intent‐to‐treat (ITT) (switch=failure, and missing=failure) and on treatment (OT) analyses.Results78 patients were included. Median follow up was 26 (0.1‐84) months. 86% were male, median age 41 (23‐69) years, 9% had AIDS, 8% were HCV+, baseline CD4 was 275 (10‐724) cells/µL and median VL 4.58 (3.02‐6.92) log. After 48 weeks, VL was<40 c/mL in 89.8% (OT), 79.7% (M=F) and 65.4% (S=F) and at 96 weeks in 88.5%, 78.9% and 61.6%, respectively. CD4 increased +246 (p<0.001) and +292 (p<0.001) cells/uL after 48 and 96 weeks, respectively. One or more drugs of the regimen were discontinued in 33 (42.3%) patients. In 15 (19.2%) patients (13 NVP, 2 ABC/3TC) therapy was stopped due to toxicity after a median of one month (in only two cases after six months of follow up): 80% of them had rash/liver toxicity. Six (7.7%) patients discontinued ART due to virologic failure, five (6.4%) because of other reasons and seven (9%) were lost to follow‐up. ALT but not AST significantly increased (+0.07 ukat/L at 96 weeks, p=0.033). A significant increase of 25%, 26% and 42% in total cholesterol, LDLc and HDLc, respectively, and a significant decrease in TC/HDL ratio (6%, p=0.008) was observed after 96 weeks.ConclusionsDespite a considerable proportion of patients had to stop therapy due to toxicity (most associated with NVP), those initially tolerating this regimen presented a high virologic and immunologic response after 96 weeks, as well as a favourable lipid profile. ABC/3TC/NVP may be a suitable alternative first regimen, mainly in countries with economic constraints.

AbstractIntroductionHIV‐controllers have the ability to spontaneously maintain viraemia at low or undetectable levels in the absence of antiretroviral treatment. Furthermore, HIV‐controllers seem to have a superior capacity to spontaneously clear hepatitis C virus (HCV) compared to non HIV‐controllers. Some of these subjects eventually lose HIV‐controller status (transient controllers), whereas some HIV‐controllers show a persistent natural HIV control (persistent controllers). We aimed to analyse whether persistent controllers have superior capacity to spontaneously clear HCV compared to transient controllers.MethodsWe recruited HIV‐controllers from January 1981 up to October 2016 with available antibodies to HCV (anti‐HCV) data (n = 744). Factors associated with HIV spontaneous control in relation to HCV status were analysed in persistent and transient HIV‐controllers with anti‐HCV positive (n = 202 and n = 138 respectively) in comparison with 1700 HCV positive non HIV‐controllers recruited from January 1981 up to March 2018, bivariate and multivariate analyses, following a logistic regression model, were applied. In addition, the factors related to the loss and time to lose HIV‐controller status were explored (n = 744) using Log rank test and Kaplan–Meier curves, in this case the multivariate analysis consisted in a Cox regression model.ResultsA higher frequency of HCV spontaneous clearance was found in persistent HIV‐controllers (25.5%) compared to non‐controllers (10.2%). After adjusting for potential confounders, as sex, age, HIV transmission risk, CD4+ T‐cell nadir and time of follow‐up, HCV clearance was independently associated with persistent HIV spontaneous control (p = 0.002; OR (95% CI) = 2.573 (1.428 to 4.633)), but not with transient spontaneous control (p = 0.119; 1.589 (0.888 to 2.845)). Furthermore, persistent HIV‐controllers were more likely to spontaneously clear the HCV in comparison with transient controllers (p = 0.027; 0.377 (0.159 to 0.893). Finally, not to lose or lengthen the time of losing this control was independently associated with HCV spontaneous clearance (p = 0.010; 0.503 (0.297 to 0.850).ConclusionsThis study shows an association between spontaneous persistent HIV‐control and HCV spontaneous clearance. The study findings support the idea of preserved immune mechanisms in persistent HIV control implicated in HCV spontaneous clearance. These results highlight persistent HIV‐controllers but not transient controllers as a good model of functional HIV cure.

[Objective] HIV controllers (HICs) spontaneously maintain HIV viral replication at low level without antiretroviral therapy (ART), a small number of whom will eventually lose this ability to control HIV viremia. The objective was to identify factors associated with loss of virological control. ; [Methods] HICs were identified in COHERE on the basis of ≥5 consecutive viral loads (VL) ≤500 copies/mL over ≥1 year whilst ART-naive, with the last VL ≤500 copies/mL measured ≥5 years after HIV diagnosis. Loss of virological control was defined as 2 consecutive VL >2000 copies/mL. Duration of HIV control was described using cumulative incidence method, considering loss of virological control, ART initiation and death during virological control as competing outcomes. Factors associated with loss of virological control were identified using Cox models. CD4 and CD8 dynamics were described using mixed-effect linear models. ; [Results] We identified 1067 HICs; 86 lost virological control, 293 initiated ART, and 13 died during virological control. Six years after confirmation of HIC status, the probability of losing virological control, initiating ART and dying were 13%, 37%, and 2%. Current lower CD4/CD8 ratio and a history of transient viral rebounds were associated with an increased risk of losing virological control. CD4 declined and CD8 increased before loss of virological control, and before viral rebounds. ; [Discussion] Expansion of CD8 and decline of CD4 during HIV control may result from repeated low-level viremia. Our findings suggest that in addition to superinfection, other mechanisms, such as low grade viral replication, can lead to loss of virological control in HICs. ; The COHERE study group has received unrestricted funding from: Agence Nationale de Recherches sur le SIDA et les Hépatites Virales (ANRS), France; HIV Monitoring Foundation, The Netherlands; and the Augustinus Foundation, Denmark. The research leading to these results received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under EuroCoord grant agreement n° 260694. ; Peer reviewed