La violencia de pareja en las pacientes que consultan por dolor torácico en urgencias / Domestic violence against women patients seen with chest pain in the emergency department

OBJETIVOS: 1) Conocer la prevalencia de violencia de pareja (VP) en las pacientes que consultan a urgencias por dolor torácico. 2)Analizar la posible asociación entre VP y presencia/control de factores de riesgo vascular (FRV), manifestaciones psíquicas de estrés, demora en la solicitud de atención, manejo del episodio y pronóstico. MÉTODOS: Se incluyó a 125 mujeres. Se realizó entrevista dirigida, test del Partner Violence Screen (PVS), seguimiento telefónico a los 30 días y revisión del historial clínico al año. RESULTADOS: Veintisiete pacientes (21,6%) tenían historia de VP, que era vigente en 4 de ellas. Las mujeres que habían sufrido VP eran más jóvenes (53,7 ± 15,0 vs 64,0 ± 18,4; p = 0,020), presentaban más frecuentemente síndrome ansioso-depresivo (57,7% vs 13,5%; p < 0,001) y tardaron más en consultar (35,0 ± 65,2 días vs 7,9 ± 25,0días; p = 0,047). Entre las mujeres mayores (≥ 65 años) existía más dislipidemia (100% vs 60,4%; p = 0,039) y peor control de la presión arterial (buen control 20% vs 78,4%; p = 0,007) en las que tenían historia de VP. No hubo diferencias en los diagnósticos, pruebas, tiempo de estancia, ingresos o evolución entre las pacientes con historia de VP o sin ella, ni hubo diferencias según la vigencia de la VP. CONCLUSIONES: La existencia actual o previa de VP en las pacientes que consultan por dolor torácico en urgencias es elevada. La existencia de VP va asociada a un retraso en la consulta y a mayor ansiedad, y puede contribuir a un mal control de los FRV, pero no afecta la evolución a medio plazo

OBJECTIVES: 1) To determine the prevalence of intimate partner violence (IPV) in patients seen in the emergency department with chest pain. 2) To analyse the possible association between IPV and presence/control of vascular risk factors (VRF), psychic manifestations of stress, delay in requesting care, care received, and prognosis. METHODS: The study was conducted on 125 women, and included a targeted interview, the Partner Violence Screen (PVS) test, a 30-day follow-up telephone interview, and a one-year follow-up clinical history review. RESULTS: A total of 27 patients (21.6%) had a history of IPV, which was present in 4 of them. Women with a history of IPV were younger (53.7 ± 15.0 vs. 64.0 ± 18.4; P = .020), had more anxiety or a depressive syndrome (57.7% vs 13.5%; P < 0.001), and consulted later (35.0 ± 65.2days vs 7.9 ± 25.0days; P = .047). Among older women ( ≥ 65years), there was more dyslipidaemia (100% vs 60.4%; P = .039) and worse blood pressure control (good control 20% vs 78.4%; P = .007) in those with a history of IPV. There were no differences in the diagnoses, tests, length of stay, admissions or prognosis among patients with or without a history of IPV, and there were no differences according to chronology of IPV. CONCLUSIONS: The current or previous existence of IPV in patients who consult for chest pain in the emergency department is high. The existence of IPV is associated with a delay in consultation and greater anxiety, and may contribute to poor control of VRF, but does not affect the prognosis in the medium term

[Domestic violence against women patients seen with chest pain in the emergency department]. / La violencia de pareja en las pacientes que consultan por dolor torácico en urgencias.

OBJECTIVES: 1) To determine the prevalence of intimate partner violence (IPV) in patients seen in the emergency department with chest pain. 2)To analyse the possible association between IPV and presence/control of vascular risk factors (VRF), psychic manifestations of stress, delay in requesting care, care received, and prognosis. METHODS: The study was conducted on 125 women, and included a targeted interview, the Partner Violence Screen (PVS) test, a 30-day follow-up telephone interview, and a one-year follow-up clinical history review. RESULTS: A total of 27 patients (21.6%) had a history of IPV, which was present in 4 of them. Women with a history of IPV were younger (53.7±15.0 vs. 64.0±18.4; P=.020), had more anxiety or a depressive syndrome (57.7% vs 13.5%; P<0.001), and consulted later (35.0±65.2days vs 7.9±25.0days; P=.047). Among older women (≥65years), there was more dyslipidaemia (100% vs 60.4%; P=.039) and worse blood pressure control (good control 20% vs 78.4%; P=.007) in those with a history of IPV. There were no differences in the diagnoses, tests, length of stay, admissions or prognosis among patients with or without a history of IPV, and there were no differences according to chronology of IPV. CONCLUSIONS: The current or previous existence of IPV in patients who consult for chest pain in the emergency department is high. The existence of IPV is associated with a delay in consultation and greater anxiety, and may contribute to poor control of VRF, but does not affect the prognosis in the medium term.

Lignin and ethylcellulose in controlled release formulations to reduce leaching of chloridazon and metribuzin in light-textured soils.

In this research, controlled release formulations (CRFs) of the herbicides chloridazon and metribuzin, identified as potential leachers, have been evaluated in soils with different texture. To prepare the CRFs, ethylcellulose (EC) and dibutylsebacate (DBS) have been used as coating agents in lignin-polyethylene glycol based formulations. Mobility experiments have been carried out in two light textured soils (sandy and sandy-loam). Breakthrough curves have shown that the use of CRFs reduces the presence of chloridazon and metribuzin in the leachate compared to technical and commercial products, being the lignin CRF coated with EC and DBS the most efficient to diminish the herbicide leaching. Mass balance study has shown a higher amount of chloridazon and metribuzin recovered in soils when these herbicides were tested as CRFs compared to technical and commercial products. The gradual release of herbicides from the CRFs resulting in a rather available levels of chloridazon and metribuzin in soil for a longer time. A good correlation between percentages of herbicide recovered in leachates and T50 values (time corresponding to 50% release of herbicide in water) was obtained, which allows to select the most appropriate CRF in each agro-environmental practice to reduce the potential pollution of groundwater by chloridazon and metribuzin.

Highly sensitive electrochemical immunosensor for IgG detection based on optimized rigid biocomposites.

In this work we present the construction of immunosensors based on graphite-epoxy which incorporate RIgG to the composite matrix. In order to improve the electrochemical properties of the immunocomposite electrodes, characterization and optimization was carried out in terms of electrochemical impedance spectroscopy and cyclic voltammetry. Consequently, taking into the account the properties required by a sensitive electrode such as high electron-transfer rate, high signal-to-noise ratio and suitable sensitivity; the optimal proportion of the transducer material (graphite-epoxy ratio) was chosen using constant amount of RIgG. The optimum composition range values, which provide these requirements, were from 16% to 17% of graphite loading. Then, the analytical properties of these immunosensors were evaluated measuring RIgG by using a competitive assay and using alkaline phosphatase-labeled antibody. Amperometric measurements were performed using hydrogen peroxide as substrate. Moreover, it has been the first time that it has been performed an optimization of the antigen-antibody ratio used in the assay, being this reduced significantly.

[High flow nasal cannula in infants: Experience in a critical patient unit]. / Cánula nasal de alto flujo en lactantes: experiencia en una unidad de paciente crítico.

INTRODUCTION: The high flow nasal cannula (HFNC) is a method of respiratory support that is increasingly being used in paediatrics due to its results and safety. OBJECTIVE: To determine the efficacy of HFNC, as well as to evaluate the factors related to its failure and complications associated with its use in infants. PATIENTS AND METHOD: An analysis was performed on the demographic, clinical, blood gas, and radiological data, as well as the complications of patients connected to a HFNC in a critical care unit between June 2012 and September 2014. A comparison was made between the patients who failed and those who responded to HFNC. A failure was considered as the need for further respiratory support during the first 48hours of connection. The Kolmogorov Smirnov, Mann-Whitney U, chi squared and the Exact Fisher test were used, as well as correlations and a binary logistic regression model for P≤.05. RESULTS: The study included 109 patients, with a median age and weight: 1 month (0.2-20 months) and 3.7kg (2-10kg); 95 percentile: 3.7 months and 5.7kg, respectively. The most frequent diagnosis and radiological pattern was bronchiolitis (53.2%) and interstitial infiltration (56%). Around 70.6% responded. There was a significant difference between failure and response in the diagnosis (P=.013), radiography (P=018), connection context (P<.0001), pCO2 (median 40.7mmHg [15.4-67 mmHg] versus 47.3mmHg [28.6-71.3mmHg], P=.004) and hours on HFNC (median 60.75hrs [5-621.5 hrs] versus 10.5hrs [1-29 hrs], P<.0001). The OR of the PCO2 ≥ 55mmHg for failure was 2.97 (95% CI; 1.08-8.17; P=.035). No patient died and no complications were recorded. CONCLUSION: The percentage success observed was similar to that published. In this sample, the failure of HFNC was only associated with an initial pCO2 ≥ 55mmHg. On there being no complications reported as regards it use, it is considered safe, although a randomised, controlled, multicentre study is required to compare and contrast these results.

Cánula nasal de alto flujo en lactantes: experiencia en una unidad de paciente crítico / High flow nasal cannula in infants: Experience in a critical patient unit

Introducción: La cánula nasal de alto flujo (CNAF) es un método de soporte respiratorio cada vez más utilizado en pediatría por sus resultados y seguridad. Objetivo: Determinar la efectividad de la CNAF, evaluar factores asociados a fracaso y complicaciones relacionadas con su uso en lactantes. Pacientes y método: Se analizaron los datos demográficos, clínicos, gasométricos, radiológicos y complicaciones de los pacientes conectados a CNAF en una unidad crítica entre junio de 2012 y septiembre de 2014. Se compararon los pacientes que fracasaron con los respondedores a CNAF, considerándose fracaso la necesidad de un mayor soporte respiratorio durante las primeras 48 h de conexión. Se utilizó test de Kolmogorov Smirnov, U de Mann-Whitney, Chi cuadrado, test exacto de Fisher, correlaciones y Modelo de regresión logística binaria para p ≤ 0,05. Resultados: Un total de 109 pacientes. Mediana de edad y peso: 1 mes (0,2-20 meses) y 3,7 kg (2-10 kg); percentil 95: 3,7 meses y 5,7 kg respectivamente. El diagnóstico y patrón radiológico más frecuente fue bronquiolitis (53,2%) e infiltrado intersticial (56%). Un 70,6% respondió. Hubo diferencia significativa entre fracaso y respuesta en el diagnóstico (p = 0,013), radiografía (p = 0,018), contexto de conexión (p < 0,0001), pCO2 (mediana 40,7 mm Hg [15,4-67 mm Hg] versus 47,3 mm Hg [28,6-71,3 mm Hg], p = 0,004) y horas de CNAF (mediana 60,75 h [5-621,5 h] versus 10,5 h [1-29 h], p < 0,0001). El OR de PCO2 ≥ 55 mm Hg para fracaso fue 2,97 (IC 95%: 1,08-8,17; p = 0,035). Ningún paciente falleció ni registró complicaciones. Conclusión: El porcentaje de éxito observado fue similar a lo publicado. En esta muestra el fracaso de CNAF solo se asoció a una pCO2 inicial ≥ 55 mm Hg. Su uso se consideró seguro al no reportarse complicaciones relacionadas a su utilización. Se requiere de un estudio multicéntrico, aleatorizado y controlado para contrastar estos resultados.

Introduction: The high flow nasal cannula (HFNC) is a method of respiratory support that is increasingly being used in paediatrics due to its results and safety. Objective: To determine the efficacy of HFNC, as well as to evaluate the factors related to its failure and complications associated with its use in infants. Patients and method: An analysis was performed on the demographic, clinical, blood gas, and radiological data, as well as the complications of patients connected to a HFNC in a critical care unit between June 2012 and September 2014. A comparison was made between the patients who failed and those who responded to HFNC. A failure was considered as the need for further respiratory support during the first 48 hours of connection. The Kolmogorov Smirnov, Mann-Whitney U, chi squared and the Exact Fisher test were used, as well as correlations and a binary logistic regression model for P ≤ .05. Results: The study included 109 patients, with a median age and weight: 1 month (0.2-20 months) and 3.7 kg (2-10 kg); 95 percentile: 3.7 months and 5.7 kg, respectively. The most frequent diagnosis and radiological pattern was bronchiolitis (53.2%) and interstitial infiltration (56%). Around 70.6% responded. There was a significant difference between failure and response in the diagnosis (P = .013), radiography (P = 018), connection context (P < .0001), pCO2 (median 40.7 mmHg [15.4-67 mmHg] versus 47.3 mmHg [28.6-71.3 mmHg], P = .004) and hours on HFNC (median 60.75 hrs [5-621.5 hrs] versus 10.5 hrs [1-29 hrs], P < .0001). The OR of the PCO2 ≥ 55 mmHg for failure was 2.97 (95% CI; 1.08-8.17; P = .035). No patient died and no complications were recorded. Conclusion: The percentage success observed was similar to that published. In this sample, the failure of HFNC was only associated with an initial pCO2 ≥ 55 mmHg. On there being no complications reported as regards it use, it is considered safe, although a randomised, controlled, multicentre study is required to compare and contrast these results.

Bentonite and anthracite in alginate-based controlled release formulations to reduce leaching of chloridazon and metribuzin in a calcareous soil.

The leaching of herbicides through soil can be minimized using controlled release formulations (CRFs). In this research, bentonite and anthracite have been used as modifying agents in alginate-based CRFs prepared with chloridazon and metribuzin. These CRFs have been evaluated in a calcareous soil. The Kf and Koc values obtained from sorption experiments in soil have demonstrated a high leaching potential for both herbicides, mainly for metribuzin. Release kinetics in soil have showed that the control of release rate of chloridazon and metribuzin was possible by using bentonite and anthracite in CRFs, being this effect greater when we use anthracite as modifying sorbent. Using an empirical equation, the time taken for 50% of the active ingredient to be released (T50(soil)) was calculated. T50 values ranged between 2.88 d for metribuzin-bentonite alginate-based granules and 14.37 d for chloridazon-anthracite alginate-based granules, being the release rate higher in metribuzin CRFs than in those prepared with chloridazon, which has lower water solubility. Besides, a linear correlation between T50 values in water and soil was obtained. Mobility experiments carried out in a calcareous soil have shown that the use of CRFs reduces the presence of herbicides in the leachate compared to technical products, mainly for chloridazon. We found that one could design a right profile in the release rate of active ingredients from CRFs in each agro-environmental situation, and thus prevent the environmental pollution derived from the use of chloridazon and metribuzin.

Traumatismo encefalocraneano en pediatría / Traumatic brain injury in pediatrics

Traumatic Brain Injury (TBI) is an important Public Health issue in Chile and the world. It represents a frequent cause of consultation, constituting a significant cause of morbidity and mortality in the population under 45 years of age. Accidents are the main reason for TBI among the pediatric population, but child abuse is an important cause in children below 2 y.o. A proper evaluation is essential to develop timely and efficient treatment that avoids or decreases brain damage and eventual complications. For this purpose, it is essential that brain physiology and physiopathological changes triggered by TBI are clear and well known. Current concepts are presented in this paper, emphasizing brain hemodynamics, metabolism, and brain self-regulation.

El traumatismo encefalocraneano (TEC) es un importante problema de salud pública tanto en Chile como en el mundo. Representa un motivo de consulta frecuente constituyendo una de las mayores causas de morbi-mortalidad en la población menor de 45 años. Los accidentes son la principal causa de TEC en la población pediátrica, pero el maltrato infantil es una causa etiológica importante a considerar en los menores de 2 años. Realizar una correcta evaluación al paciente con TEC es fundamental para instaurar un tratamiento oportuno y eficiente con el fin de evitar y/o disminuir el daño cerebral y así prevenir eventuales complicaciones. Para ello es imprescindible el conocimiento de la fisiología cerebral y los cambios fisiopatológicos que se desencadenan posterior al TEC, conceptos que son revisados en este artículo con énfasis en la hemodinamia cerebral, metabolismo y autorregulación cerebral.

Amino acid supplementation of hydrolyzed feather meal diets for finisher pigs.

The objective of this study was to determine the possibility of replacing soybean meal (SBM) in finisher pig diets completely with hydrolyzed feather meal (FM). Forty-five gilts and 45 castrated males (57.8+/-0.8 kg of BW; 3 gilts or 3 castrated males/pen) were randomly assigned to 5 finisher-1 diets with 6 pens per diet. At an average pen BW of 81.0+/-1.4 kg, pigs were offered finisher-2 diets. Corn-SBM, finisher-1 and finisher-2 positive control (PC) diets were formulated to contain 6.1 and 4.7 g of apparent ileal digestible (AID) Lys/kg, respectively. Corn-FM negative control (NC) diets were formulated to be iso-N to the PC diets. The NC diets were supplemented with Lys and Trp (NRC; NC + Lys and Trp) to alleviate apparent deficiencies based on AID AA in FM reported by the 1998 NRC. In addition, the NC diets were supplemented further with the third limiting AA, Thr (40+3AA; NC + Lys, Trp, and Thr), and fourth and fifth limiting AA, His and Ile (40+5AA; NC + Lys, Trp, Thr, His, and Ile), based on the assumption that the apparent ileal digestibility of all indispensable AA in FM is 40%. Pigs had ad libitum access to feed and water. At the end of the study (112.1+/-1.8 kg), blood samples were collected from all pigs before slaughter. As expected, overall ADFI, AID Lys (representing indispensable AA) intake (LysI), ADG, and G:F were greater and BW gain:LysI (G:LysI) was less in pigs fed the PC diet than those fed the NC diet (P<0.001). Pigs fed the NRC diet grew slower than those fed the PC diet (P=0.004), and their G:LysI tended to be less than those fed the PC (P=0.083) or the 40+3AA and 40+5AA diets (P=0.094). Greater fat-free lean percentage (P=0.005), fat-free lean gain (LG; P<0.001), and LG:F (P<0.001) were observed in pigs fed the PC diet compared with those fed the NC diet, but their LG:F or LG:LysI was similar to those fed the NRC diet. However, LG:F (P=0.030) and LG:LysI (P=0.028) were greater in pigs fed the 40+3AA and the 40+5AA diets than those fed the NRC diet. Pigs fed the 40+5AA diet tended to utilize AID Lys more efficiently for LG than those fed the 40+3AA diet (P=0.068). Subjective meat color (P<0.001), firmness (P=0.004), and marbling (P<0.001) scores were greater in pigs fed the 40+5AA diet than those fed the 40+3AA diet. Diets seemed to have no clear effect on the weight of liver, kidney, and heart or serum urea N and triacylglycerides. Pigs fed the PC diet had more serum albumin and total protein (P<0.001), but less glucose (P=0.031) and cholesterol (P<0.001) than those fed the NC diet. Serum total protein was greater (P=0.031) in pigs fed the 40+5AA diet than those fed the 40+3AA diet. The results indicated that the corn-FM diets were not as effective as the corn-SBM diet in supporting BW gain of finisher pigs. However, the results seemed to indicate that pigs fed the corn-FM diet supplemented with the necessary AA can utilize feed and AA for BW gain and lean gain as efficiently as those fed the corn-SBM diet. Further research is needed to explore fully the optimal AA supplementation strategy to effectively utilize FM for pig production.

Electronic tongues in flow analysis.

This review presents the evolution of recent flow-based analytical systems, characterized by the use of arrays of sensors as a detection scheme. For the proper processing of the complex responses generated, the systems require the use of advanced chemometric treatment, in which received the term "electronic tongue". Applications employing the flow injection analysis (FIA) and sequential injection analysis (SIA) are described. Chronologically, the progresses made by different research groups are shown, emphasizing their final applications in real problem solving.

Enfermedad injerto contra huésped asociada a transfusión / Graft versus hot disease associated to transfusion

Background: Transfusion-associated graft versus host disease (AT-GVDH) is produced by an aggressive host inmune response secondary to the incorporation and proliferation of T lymphocytes in blood products. AT-GVDH affects immunocompromised patients with cellular immune dysfunction, but also immunocompetent persons with certain genetic characteristics. It presents as an acute syndrome that involves skin, gastrointestinal tract, liver and bone marrow. The use of irradiated blood products represents the only therapeutic choice. Objective: To describe a severe and rarely diagnosed pathological condition associated to frequent clinical practice. Case-report: A 6 months-old child with a severe combined immunodeficiency (pathology with high risk of AT-GVDH) who developed this disease after a filtered red blood cell transfusion. Conclusions: The AT-GVDH is an uncommon iatrogenic and highly lethal complication related to the use of blood products. It implies high degree of clinical suspicion because underlying pathologies of risk may be unknown. The therapy is poor, being prevention the only available alternative. It is fundamental to know the risks and complications in using blood products, in order to determine correctly their indications.

Introducción: La Enfermedad Injerto Contra Huésped asociada a Transfusiones (EICH-AT) se produce por una respuesta inadecuada y autodestructiva del organismo frente a la incorporación y proliferación de linfocitos T presentes en los hemoderivados. Afecta fundamentalmente a pacientes inmunosuprimidos de predominio celular, aunque también a inmunocompetentes con determinadas características genéticas. Se manifiesta como un síndrome agudo que compromete piel, hígado, tracto gastrointestinal y médula ósea, confundible al inicio con enfermedades banales frecuentes. Actualmente la prevención, mediante el uso de hemoderivados irradiados representa la única medida terapéutica demostrada. Objetivo: Presentar una entidad patológica grave y poco reconocida asociada a una práctica clínica habitual. Caso clínico: Lactante de 6!4 meses portadora de una Inmunodeficiencia Combinada Severa que posterior a una transfusión de glóbulos rojos filtrados desarrolló esta enfermedad. Conclusiones: La EICH-AT es una complicación iatrogénica infrecuente, altamente letal y potencialmente prevenible relacionada a la administración de hemoderivados. Requiere un alto grado de sospecha clínica, mas aun en menores de 1 año en quienes pueden desconocerse patologías de riesgo subyacentes.

Controlled-release formulations of cyromazine-lignin matrix coated with ethylcellulose.

An encapsulation system was developed and designed to give long-lasting effectiveness of the insect growth regulator cyromazine. Cyromazine was incorporated in lignin-poly (ethylene glycol) (PE) controlled-release formulations by means of a melting process. The basic formulation [lignin (65%)-PE (20%)-cyromazine (15%)] was coated in a Wurster-type fluidized-bed equipment using two different amounts of ethylcellulose. That of the highest one was modified by the addition of a plasticizer, dibutyl sebacate (DBS). The effect on cyromazine release rate caused by the incorporation of ethylcellulose and DBS in lignin-PE formulation was studied by immersion of the granules in water under static conditions. Using an empirical equation, the time taken for 50% of the active ingredient to be released into water (T(50)) was calculated. From the analysis of the T(50) values, the influence of ethylcellulose appears clearly defined, observing a delay in release rate of cyromazine with respect to the basic lignin-PE formulation. In addition, the granules coated with ethylcellulose and the plasticizer lead the slowest release rate into water. The release of cyromazine into water is controlled by a diffusion mechanism. The thickness and permeability of the coating film are the most important factors that affect cyromazine release.

Expresión de óxido nítrico sintetasa en mucosa sinusal de pacientes portadores de sinusitis crónica versus controles / Expression of nitric oxide synthase in sinus mucosa of chronic sinusitis patients vs controls

Introducción: El óxido nítrico producido en las cavidades paranasales juega un importante rol en la fisiología nasal ya que aumenta la frecuencia del batido ciliar, optimiza el barrido mucociliary tiene un efecto bacteriostático y virustático. Diversos estudios muestran que el óxido nítrico nasal exhalado en pacientes con rinosinusitis crónica es significativamente más bajo que en sujetos sanos. Esto podría estar determinado por una alteración en la difusión del óxido nítrico a través de los ostia de drenaje obstruidos o por una menor producción de óxido nítrico por parte de los portadores de rinosinusitis crónica. En este último caso, esto podría corresponder al evento primario en la etiopatogenia de la rinosinusitis crónica. Objetivos: Estudiar y comparar cualitativamente con técnica de inmunohisto-química la expresión de las isoformas e-NOS e I-NOS de la óxido nítrico sintetasa en mucosa sinusal de pacientes con rinosinusitis crónica y pacientes controles, sin patología rinosinusal infecciosa o alérgica. Material y método: Para responder a esta interrogante se realizó un estudio comparativo de casos y controles, con el objetivo de cuantificar con técnica de inmunohistoquímica la expresión de las isoformas endotelial e inducible de la óxido nítrico sintetasa en mucosa sinusal de pacientes con rinosinusitis crónica y pacientes controles sin patología rinosinusal infecciosa o alérgica. Resultados: Ingresan al estudio un total de 11 pacientes. Seis de ellos son el grupo control y 5 con sinusitis crónica. Ambos grupos presentan resultados similares. Conclusión: Los resultados no muestran ninguna diferencia en la expresión de óxido nítrico sintetasa, tanto en su isoforma endotelial como inducible, en la mucosa sinusal de pacientes portadores de rinosinusitis crónica comparado con sujetos sanos.

Introduction. Nitric oxide produced in the paranasal sinuses plays an important role in nasal physiology because it increases ciliary beat frequency, improves mucociliary clearance and has a bacteriostatic and virustatic effect. Several studies have shown that exhaled nasal nitric oxide was substantially lower in chronic sinusitis patients, compared to healthy subjects. This could be determined by altered nitric oxide diffusion through obstructed drainage ostia, or by chronic sinusitis patients having lower nitric oxide production. Aims. To qualitatively compare by immunocytochemistry the expression of the iNOS and eNOS isoforms of nitric oxide synthase in the sinus mucosa of chronic sinusitis patients and control subjects. Materials and methods. A case-control comparative study was carried out in order to compare by immunocytochemistry the expression of inducible and epithelial isoforms of nitric oxide synthase in nasal mucosa of chronic sinusitis patients and control subjects, with no infectious or allergic rhinosinusal pathology. Results. The results show no difference in the expression of the inducible or epithelial isoform of nitric oxide synthase in the nasal mucosa of chronic sinusitis patients as compared to healthy subjects.

Albúmina en el paciente crítico: ¿mito o realidad terapéutica?: [revisión] / Albumin in the critically ill patient: myth or real therapeutics?: [review]

Under normal conditions, the plasmatic oncotic pressure is determined mainly by albumin. Numerous trials in critically ill patients have showed that hypoalbuminemia is associated to poor outcome. So, the administration of exogenous albumin is an attractive therapeutic strategy, widely spread in different clinical scenes. Nevertheless, its use has been questioned in the last period and up to date there is no clear evidence of the real effectiveness and/or utility. This article reviews the physiological and pathophysiological concepts that would justify the use of synthetic albumin. According to current literature, discussion about the rationality of its use in different pathological situations exists, trying to outline those clinical conditions that could or could not benefit with its administration. Certainly, clinical guidelines with recommendations about the benefits and indications of this therapy are required. Hypoalbuminemia in the critically ill patient is produced principally by redistribution, secondary to changes in capillary permeability: "transcapillary leakage". The crucial interrelation between osmotic plasmatic pressure and albumin concentration in healthy individuals is lost in several critical conditions. Agreements on indications for use of albumin have not been achieved, since in different clinical context (resuscitation, sepsis, post-surgical, burns, nephrotic syndrome, ARDS) there are no significant advantages in morbidity and mortality of critically ill patients, compared to other cristalloids or synthetic colloids used. It is extremely important to develop clinical guidelines with recommendations on benefits and indications for the use of albumin in critically ill patients.

La albúmina es la principal determinante de la presión oncótica plasmática. La reducción de sus niveles séricos se asociaría a malos resultados clínicos, fundamentalmente, en la población de pacientes críticos, por lo cual su administración exógena resulta una estrategia terapéutica atractiva y ampliamente difundida. Su uso, sin embargo, ha sido cuestionado en el último tiempo, no existiendo a la fecha una clara evidencia de su real eficacia y/o utilidad. Objetivo: Revisar los conceptos fisiológicos y fisiopatológicos que subyacen al uso de albúmina sintética y evaluar la racionalidad de su utilización en distintas situaciones patológicas, intentando perfilar las condiciones clínicas que pudieran o no beneficiarse de su administración. La hipoalbuminemia en el paciente crítico está dada principalmente por un fenómeno de redistribución, secundario a cambios en la permeabilidad capilar (escape transcapilar), y la correlación entre presión osmótica plasmática y concentración de albúmina en individuos sanos, se pierde en condiciones críticas. A pesar de la literatura existente, no se han logrado acuerdos sobre las indicaciones para el uso de albúmina, ya que en los distintos contextos clínicos revisados, (resucitación, sepsis, post quirúrgicos, quemados, síndrome nefrótico, SDRA), no aparecen ventajas significativas en la morbimortalidad al compararla con el uso de cristaloides u otros coloides sintéticos, sin dejar de mencionar además el costo económico que representa su uso. Se requieren guías clínicas de consenso, basadas en la evidencia, que establezcan recomendaciones acerca de los beneficios e indicaciones de esta herramienta terapéutica, que por ahora aparece con indicaciones muy limitadas en los pacientes críticos.

Modifying sorbents in controlled release formulations to prevent herbicides pollution.

The herbicides chloridazon and metribuzin, identified as groundwater pollutants, were incorporated in alginate-based granules to obtain controlled release properties. In this research the effect of incorporation of sorbents such as bentonite, anthracite and activated carbon in alginate basic formulation were not only studied on encapsulation efficiency but also on the release rate of herbicides which was studied using water release kinetic tests. In addition, sorption studies of herbicides with bentonite, anthracite and activated carbon were made. The kinetic experiments of chloridazon and metribuzin release in water have shown that the release rate is higher in metribuzin systems than in those prepared with chloridazon, which has lower water solubility. Besides, it can be deduced that the use of sorbents reduces the release rate of the chloridazon and metribuzin in comparison to the technical product and to the alginate formulation without sorbents. The highest decrease in release rate corresponds to the formulations prepared with activated carbon as a sorbent. The water uptake, permeability, and time taken for 50% of the active ingredient to be released into water, T(50), were calculated to compare the formulations. On the basis of a parameter of an empirical equation used to fit the herbicide release data, the release of chloridazon and metribuzin from the various formulations into water is controlled by a diffusion mechanism. Sorption capacity of the sorbents for chloridazon and metribuzin, ranging from 0.53mgkg(-1) for the metribuzin sorption on bentonite to 2.03x10(5)mgkg(-1) for the sorption of chloridazon on the activated carbon, was the most important factor modulating the herbicide release.

Cosorption study of organic pollutants and dissolved organic matter in a soil.

In this study we have evaluated the effects of dissolved organic matter (DOM) on sorption of imidacloprid, 3,4-dichloroaniline (3,4-DCA) and 4-bromoaniline (4-BA) on a typical calcareous soil (Luvic Xerosol) from south-eastern Spain. Two different types of DOM were used, that is to say, dissolved natural organic matter extracts from a commercial peat (DNOM) and a high-purity tannic acid (TA) solution. The experiments were carried out in a 0.01 M CaCl2 aqueous medium at 25 degrees C. The results indicated that the presence of both DNOM and TA, over a concentration range of 15-100 mg L(-1), produced an increase in the amount of 3,4-DCA and 4-BA sorbed and a decrease in the amount of imidacloprid retained on the soil studied. A modified distribution coefficient, K(doc), has been proposed as a safer parameter for soil sorption predictions of organic pollutants and it could be of help to model the fate of these in the environment.

Use of bentonite and activated carbon in controlled release formulations of carbofuran.

Controlled release systems (CRS), unlike the conventional formulations, facilitate a gradual and controlled discharge of the pesticides, reducing the losses by evaporation and leaching and minimizing pesticide pollution. In this study, carbofuran-an insecticide-nematicide identified as a groundwater pollutant-was incorporated in alginate-based granules to obtain controlled release properties. The effect on carbofuran release rate caused by the incorporation of bentonite, activated carbon, and different mixtures of both sorbents in alginate basic formulation was studied by immersion of the granules in water. The water uptake, sorption capacity of the sorbent, permeability, and time taken for 50% of the active ingredient to be released into water, T(50), were calculated by the comparison of the preparations. T(50) values were higher for those formulations containing bentonite and/or activated carbon (T(50) values range from 14.76 h for the alginate formulation containing only bentonite as the sorbent to 29.5 weeks for the alginate formulation containing only activated carbon as the sorbent) than for the preparation without these sorbents (11.72 h). On the basis of a parameter of an empirical equation used to fit the insecticide-nematicide release data, it appears that the release of carbofuran from the various formulations into water is controlled by a diffusion mechanism. The sorption capacity of the sorbents for carbofuran was the most important factor modulating carbofuran release. In addition, it was observed that there is a linear correlation of the T(50) values and the content of activated carbon in dry granules.

Simultaneous determination of phenolic compounds by means of an automated voltammetric "electronic tongue".

This contribution describes the simultaneous determination of three phenolic compounds, o-cresol, p-chlorophenol and 4-chloro-3-methylphenol, using direct oxidation and amperometric detection coupled by signal deconvolution, accomplished via chemometric methods. Direct oxidation of phenolic compounds is performed at the surface of an epoxy-graphite transducer, by linear scan voltammetry. Due to strong signal overlapping, artificial neural networks (ANNs) were used during data treatment, in a combination of chemometrics and electrochemical sensors known as an "electronic tongue". To calibrate this system properly, a total of 80 mixed samples were prepared automatically by employing a sequential injection analysis (SIA) system designed to automatically generate the information needed to train the network. The phenolic compound concentration varied from 1 to 70 microM for o-cresol, from 0.5 microM to 140 microM for p-chlorophenol and from 1 microM to 100 microM for 4-chloro-3-methylphenol. A good prediction capability was obtained, with correlation coefficients >0.964 when the obtained values were compared with those expected for a set of 24 external test samples not used for training. The results presented here indicate that this technique is a simple and robust analytical method of environmental interest.

Effects of dissolved organic carbon on sorption of 3,4-dichloroaniline and 4-bromoaniline in a calcareous soil.

To evaluate the effects of dissolved organic carbon on sorption of 3,4-dichloroaniline (3,4-DCA) and 4-bromoaniline (4-BA) on soils, batch sorption experiments were carried out. The soil used was a typical calcareous soil from south-eastern Spain. Two different types of dissolved organic carbon were used, that is, dissolved organic carbon extracts from a commercial peat (DOC-PE) and high-purity tannic acid (DOC-TA). The experiments were carried out in a 0.01 M CaCl2 aqueous medium at 25 degrees C. The results obtained from the sorption experiments show that the presence of both DOC-PE and DOC-TA, over a concentration range of 15-100 mg l-1, produced in all cases, an increase in the amount of 3,4-DCA and 4-BA adsorbed on the soil studied.

Determination of phenolic compounds by a polyphenol oxidase amperometric biosensor and artificial neural network analysis.

The determination of phenolic compounds is significant given its toxicity, even at very low concentration levels. Amperometric determination of phenols is a simple technique available. Direct oxidation of phenols can be used, but another possibility is the use of polyphenol oxidase (tyrosinase) enzyme biosensors that oxidises the phenolic compounds into their corresponding quinones. Reduction of the resulting quinones accomplishes the amplification of the amperometric signal, as long as the result of the reduction process is the corresponding cathecol, this being able to be oxidised again by the polyphenol oxidase immobilized on the surface of the biosensor. In this communication, simultaneous determination of different phenols was carried out combining biosensor measurements with chemometric tools, in what is known as electronic tongue. The departure information used was the overlapped reduction voltammogram generated with the amperometric biosensor based on polyphenol oxidase. Artificial Neural Networks (ANN) were used for extraction and quantification of each compound. Phenol, cathecol and m-cresol formed the three-analyte study case resolved in this work. Good prediction ability was attained, and so, the separate quantification of these three phenols was accomplished.