A previous study explored factors discriminating colonization and true infection among non-transplant, non-neutropenic patients with repeated Aspergillus spp. isolation from lower respiratory samples. The present study explored the evolution of patients with Aspergillus colonization in that study to determine the percentage of cases progressing to aspergillosis and time to development. Clinical records were retrospectively reviewed (for each patient from his end date in the past study) and data from all respiratory processes suffered by patients up to April 2015 were recorded. Comparisons of variables were performed between colonized patients that developed aspergillosis and those that did not. A Kaplan-Meier curve was used to describe time to development of aspergillosis in chronic obstructive pulmonary disease (COPD) patients for II-IV stages of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. Sixty seven colonized patients were followed, 12 of them (17.9%) developed aspergillosis. Diagnoses included six tracheobronchitis (4 invasive, 2 simple tracheobronchitis), four pulmonary disease (2 invasive pulmonary aspergillosis, 2 chronic pulmonary aspergillosis), one allergic bronchopulmonary aspergillosis and one pulmonary aspergilloma. Up to 47 (70.4%) of the study patients presented COPD. Among patients developing aspergillosis COPD was more frequent (100%) than among those that did not develop aspergillosis (35 out of 55; 63.6%) (p = 0.012), as well as GOLD IV patients were more frequent among COPD patients developing aspergillosis than among COPD patients that did not (50.0 vs. 26.1%, p = 0.046). Mean time to development of aspergillosis was 18.4 months (median: 8.5) with a wide range (1–58). Overtime, the percentage of patients developing aspergillosis was significantly higher among GOLD IV patients than among GOLD II-III patients (p = 0.032). The high percentage of cases progressing to aspergillosis among colonized patients, especially among those with COPD (25.5%), stresses the importance of colonization as risk factor, and creates awareness of the possible change from colonization to invasive disease in GOLD IV patients.

Isolation of Aspergillus from lower respiratory samples is associated with colonisation in high percentage of cases, making it of unclear significance. This study explored factors associated with diagnosis (infection vs. colonisation), treatment (administration or not of antifungals) and prognosis (mortality) in non-transplant/non-neutropenic patients showing repeated isolation of Aspergillus from lower respiratory samples.

Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by the generation of anti-DNA autoantibodies due to exposure of immune cells to excessive amounts of extracellular DNA. Lack of P-selectin in mice induces the development of a lupus-like syndrome and patients with cutaneous lupus have reduced P-selectin expression in skin vessels. Using flow cytometry we analyzed in healthy donors and patients the expression of P-selectin Glycoprotein Ligand-1 (PSGL-1) in circulating neutrophils and the implication of PSGL-1/P-selectin interaction in neutrophil extracellular traps (NETs) generation. We found a statistical significance that neutrophils from active SLE patients have a reduced expression of PSGL-1 and low levels of PSGL-1 in neutrophils from SLE patients associated with the presence of anti-dsDNA antibodies, clinical lung involvement, Raynaud’s phenomenon, and positive lupus anticoagulant. PSGL-1 is present along the DNA in the NET. In healthy donors, neutrophil interaction with immobilized P-selectin triggers Syk activation, increases the NETs percentage and reduces the amount of DNA extruded in the NETs. In active SLE patients, neutrophil interaction with P-selectin does not activate Syk or reduce the amount of DNA extruded in the NETs, that might contribute to increase the extracellular level of DNA and hence, to disease pathogenesis.

Despite the progress achieved in recent decades, tuberculosis continues to be a major public health problem in wide areas of the world geography, and caused more than 1.6 million deaths in 2017. The eruption of cases with multidrug-resistant tuberculosis and extremely resistant hinders its healing and its progressive eradication. Fortunately, in the past few years, molecular techniques capable of diagnosing the disease in a few hours have been introduced, also detecting genetic mutations that encode resistance to the most active drugs in its cure. With the incorporation of bedaquiline and delamanide, we count on new shorter, more effective and less toxic treatment schemes for resistant cases. The future of the fight against tuberculosis must be based on clinical suspicion in the most vulnerable groups (elderly, immunosuppressed and immigrants), an accurate and early diagnosis, a short treatment with oral drugs and the inclusion of solidarity socioeconomic strategies that improve the situation of the most vulnerable countries and groups.

A pesar de los avances obtenidos en los últimos años, la tuberculosis sigue siendo un problema relevante de salud pública en muchas zonas geográficas del mundo. La tuberculosis es el paradigma de enfermedad infecciosa con un alto componente social, y en su abordaje no pueden soslayarse las medidas tendentes a disminuir la pobreza, las desigualdades económicas y la integración de los colectivos más vulnerables. Por ello, la solidaridad y la justicia social son términos asociados al control de esta enfermedad. La Red TBS, integrada por diversas instituciones nacidas de la sociedad civil, intenta informar a la sociedad y a los profesionales sobre aspectos de prevención, control, diagnóstico, tratamiento e investigación de la tuberculosis, intentando evitar el estigma que acompaña todavía a muchos pacientes. Entre las actividades que organiza la Red TBS se encuentran, entre otras, el Cinefórum Solidario (en prisiones, locales de Cruz Roja y ONGs), Informa TB y Jornadas de Actualización.