Penfigoide ampolloso de origen idiopático

Introducción: El penfigoide ampolloso es una dermatosis vesicular ampollosa autoinmunitaria subepidérmica, asociada a la formación de autoanticuerpos que reconocen autoantígenos en la zona de la membrana basal. El tratamiento inmunomodulador con corticoides es la primera línea en el control de la enfermedad. Objetivo: Presentar el caso clínico de un paciente con diagnóstico de penfigoide ampolloso de origen idiopático. Caso clínico: Paciente masculino de 81 años con lesiones ampollosas dolorosas a la palpación de contenido serohemático, tamaño variado, bordes regulares y base eritematosa a nivel generalizado. La evaluación inicial sugiere diagnóstico de penfigoide ampolloso e infección bacteriana activa de las lesiones en la piel. Se solicitan exámenes de laboratorio e imágenes diagnósticas, se descartan etiologías infecciosas, autoinmunes o neoplásicas asociadas, se inicia tratamiento con corticosteroides intravenosos con adecuada evolución clínica. Finalmente, no se identifican enfermedades asociadas a las lesiones ampollosas del paciente. Conclusión: El penfigoide ampolloso es una entidad poco frecuente, con una elevada tasa de mortalidad si se realiza un diagnóstico y tratamiento tardío. Reconocer las principales manifestaciones y variantes clínicas de esta enfermedad permite un oportuno enfoque diagnóstico y terapéutico, este último basado en el control de la respuesta inflamatoria contra la piel y otros órganos.

Introduction: Bullous pemphigoid is a subepidermal autoimmune bullous vesicular dermatosis associated with the formation of autoantibodies that confirm autoantigens in the basement membrane area. Immunomodulatory treatment with corticosteroids is the first line in the control of the disease. Objective: To present the clinical case of a patient diagnosed with a bullous pemphigoid of idiopathic origin. Clinical case: 81-year-old male patient with blistering lesions that are painful on palpation with serohematic content, varied in size, regular borders and a generalized erythematous base; that the initial evaluation suggests a diagnosis of bullous pemphigoid and active bacterial infection of the skin. Laboratory tests and diagnostic images are requested, infectious, autoimmune or associated neoplastic etiologies are ruled out, treatment with intravenous corticosteroids is started with adequate clinical evolution. Finally, no diseases associated with the patient's blistering lesions were identified. Conclusion: Bullous pemphigoid is a rare entity, with a high mortality rate if a late diagnosis and treatment is performed. Recognizing the main manifestations and clinical variants of this disease allows for a timely diagnostic and therapeutic approach, the latter based on the control of the inflammatory response against the skin and other organs.

Recent Trends in Magnetic Polymer Nanocomposites for Aerospace Applications: A Review.

Polymers have had an enormous impact on science and technology, and their interest relating to the development of new macromolecular materials has exponentially increased. Polymer nanocomposites, materials based on a polymeric matrix covalently coupled to reinforcement, display properties of both components. In the aerospace industry, polymer nanocomposites are attractive due to their promising characteristics, among which lightness, mechanical and thermal resistance, radiation and corrosion resistance, and conductive and magnetic properties stand out. The use of them, instead of metal-based materials, has allowed the optimization of design processes and applications in order to provide safer, faster, and eventually cheaper transportation in the future. This comparative review collects the most relevant and prominent advances in the development of polymer nanocomposites with aerospace applications starting from basic aspects such as the definition of polymer nanocomposite to more specialized details such as synthesis, characterization, and applications, in addition to proposing new research branches related to this topic.

Polymer-Magnetic Semiconductor Nanocomposites for Industrial Electronic Applications.

Nanocomposite materials have acquired great importance, as have similar composite materials on a macroscopic scale, because the reinforcement complements the defects in the properties of the matrix, thus obtaining materials with better mechanical, thermal, and electrical properties, among others. At the same time, the importance and research of polymeric nanocomposites reinforced with nanoparticles of various types have grown. Among those that have stood out the most in the electronics industry are polymeric matrices reinforced with nanoparticles that present dual behavior, that is, both magnetic and semiconductor. This property has been very well used in developing electronic devices such as televisions, computers, and smartphones, which are part of everyday life. In this sense, this review presents a compilation of the synthetic methods to produce polymer nanocomposites with dual magnetic and semiconductor behavior and their potential applications within electronic fields and new relevant trends.

Polymeric Composite of Magnetite Iron Oxide Nanoparticles and Their Application in Biomedicine: A Review.

A broad spectrum of nanomaterials has been investigated for multiple purposes in recent years. Some of these studied materials are magnetics nanoparticles (MNPs). Iron oxide nanoparticles (IONPs) and superparamagnetic iron oxide nanoparticles (SPIONs) are MNPs that have received extensive attention because of their physicochemical and magnetic properties and their ease of combination with organic or inorganic compounds. Furthermore, the arresting of these MNPs into a cross-linked matrix known as hydrogel has attracted significant interest in the biomedical field. Commonly, MNPs act as a reinforcing material for the polymer matrix. In the present review, several methods, such as co-precipitation, polyol, hydrothermal, microemulsion, and sol-gel methods, are reported to synthesize magnetite nanoparticles with controllable physical and chemical properties that suit the required application. Due to the potential of magnetite-based nanocomposites, specifically in hydrogels, processing methods, including physical blending, in situ precipitation, and grafting methods, are introduced. Moreover, the most common characterization techniques employed to study MNPs and magnetic gel are discussed.

Hydrogels Classification According to the Physical or Chemical Interactions and as Stimuli-Sensitive Materials.

Hydrogels are attractive biomaterials with favorable characteristics due to their water uptake capacity. However, hydrogel properties are determined by the cross-linking degree and nature, the tacticity, and the crystallinity of the polymer. These biomaterials can be sorted out according to the internal structure and by their response to external factors. In this case, the internal interaction can be reversible when the internal chains are led by physicochemical interactions. These physical hydrogels can be synthesized through several techniques such as crystallization, amphiphilic copolymers, charge interactions, hydrogen bonds, stereo-complexing, and protein interactions. In contrast, the internal interaction can be irreversible through covalent cross-linking. Synthesized hydrogels by chemical interactions present a high cross-linking density and are employed using graft copolymerization, reactive functional groups, and enzymatic methods. Moreover, specific smart hydrogels have also been denoted by their external response, pH, temperature, electric, light, and enzyme. This review deeply details the type of hydrogel, either the internal structure or the external response. Furthermore, we detail some of the main applications of these hydrogels in the biomedicine field, such as drug delivery systems, scaffolds for tissue engineering, actuators, biosensors, and many other applications.

Interaction between Filler and Polymeric Matrix in Nanocomposites: Magnetic Approach and Applications.

In recent years, polymer nanocomposites produced by combining nanofillers and a polymeric matrix are emerging as interesting materials. Polymeric composites have a wide range of applications due to the outstanding and enhanced properties that are obtained thanks to the introduction of nanoparticles. Therefore, understanding the filler-matrix relationship is an important factor in the continued growth of this scientific area and the development of new materials with desired properties and specific applications. Due to their performance in response to a magnetic field magnetic nanocomposites represent an important class of functional nanocomposites. Due to their properties, magnetic nanocomposites have found numerous applications in biomedical applications such as drug delivery, theranostics, etc. This article aims to provide an overview of the filler-polymeric matrix relationship, with a special focus on magnetic nanocomposites and their potential applications in the biomedical field.

Synthesis and Antimicrobial Properties of Highly Cross-Linked pH-Sensitive Hydrogels through Gamma Radiation.

The design of new polymeric systems for antimicrobial drug release focused on medical/surgical procedures is of great interest in the biomedical area due to the high prevalence of bacterial infections in patients with wounds or burns. For this reason, in this work, we present a new design of pH-sensitive hydrogels copolymerized by a graft polymerization method (gamma rays), intended for localized prophylactic release of ciprofloxacin and silver nanoparticles (AgNPs) for potential topical bacterial infections. The synthesized hydrogels were copolymerized from acrylic acid (AAc) and agar. Cross-linked hydrogel film formation depended on monomer concentrations and the degree of radiation used (Cobalt-60). The obtained hydrogel films were characterized by attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR), thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), and mechanical testing. The swelling of the hydrogels was evidenced by the influence of their pH-sensitiveness. The hydrogel was loaded with antimicrobial agents (AgNPs or ciprofloxacin), and their related activity was evaluated. Finally, the antimicrobial activity of biocidal-loaded hydrogel was tested against Escherichia coli (E. coli) and methicillin-resistant Staphylococcus aureus (MRSA) on in vitro conditions.

Perspectivas actuales sobre el uso terapéutico del veneno de serpientes / Current perspectives on the therapeutic use of snake venom

Durante años los venenos de serpiente han sido empleados con ciertos fnes terapéuticos los cuales han sido relativamente poco estudiados. La mayoría de los venenos de serpientes poseen un sin número de moléculas con actividad concreta sobre proteínas y receptores específcos del cuerpo humano. Estas características convierten a los venenos en fuentes de inspiración para diseñar nuevas moléculas con actividad farmacológica, que de cierta forma contribuyen a proponer tratamientos médicos nuevos para el cáncer, la trombosis, la esclerosis múltiple, los trastornos neuromusculares o algunos trastornos cardiovasculares. En este artículo se revisa las principales proyecciones terapéuticas de los distintos venenos de serpientes que actualmente se están considerando para la industria farmacéutica como herramientas terapéuticas innovadoras para el desarrollo de nuevos fármacos

Historically, snake venoms have been used as a therapeutic option to treat several pathologies worldwide. These activities have been studied due to the presence of several proteins and molecules that have important molecular activity with human receptors. These features are currently been considered as one important source of inspiration to design new molecules with pharmacological activity, specially in diseases like cancer, thrombosis, multiple sclerosis, neuromuscular disorders and cardiovascular disorders. In this article we review the principal therapeutic projections that are currently being considered for the pharmaceutical industry as an innovative and therapeutic tool for the development of new drugs

Las residencias para personas con Trastorno Mental Grave como un recurso Terapéutico-Rehabilitador / The residences for persons with Several Mental Disorder as a Therapeutic-Rehabilitation resource

Introducción: El desarrollo de lugares de vida para personas con TMG está significando un factor importante en la consolidación de la atención comunitaria en Salud Mental. Las residencias deben considerarse como un lugar de rehabilitación psicosocial, al modificar una situación psicosocial disfuncional que influye negativamente en la calidad de vida y en la integración social del paciente. En esta línea se plantea el presente estudio con El objetivo: de evaluar la evolución de los residentes ingresados en las residencias Roger de Llúria, Tres Pins y Begur, (gestionadas por la Fundación de Salud Mental CPB), en sus dos primeros años de ingreso y poder definir los aspectos de mejoría en los usuarios. Material y Método: La muestra inicial es de 88 personas (usuarios ingresados durante los años. (2009- 2011). Se comparan las variaciones en el tiempo de ingreso psiquiátrico, la utilización de recursos de rehabilitación comunitaria, la estabilidad clínica, la realización de Actividades de la Vida Diaria (AVD) y la calidad de vida (desarrollo personal y social); tomando como valorares la información recogida durante el año anterior a su incorporación a la residencia y a los dos años de vinculación. Resultados y Conclusiones: Se puede afirmar que la estancia en las residencies favorece la estabilidad clínica del usuario, reduciendo el número de ingresos y su tiempo de estancia. El residente mejora en el funcionamiento general en las AVD, hábitos de salud y relaciones personales, recuperando su estatus de ciudadano, más activo y autónomo. La mejora en el ajuste social y ocupacional se refleja en el aumento de recursos de rehabilitación utilizados y la mayor participación en la vida comunitaria (tanto dentro como fuera de la residencia) (AU)

Introduction: The development of housing places for people with SMD is becoming an important factor in the consolidation of community care in mental health. Residences should be considered as a psychosocial rehabilitation place, modifying a dysfunctional psychosocial situation that negatively affects quality of life and social integration of the patient. In this line arises the present study in order to assess the evolution of the residents admitted to Roger de Llúria, Begur and Tres Pins residences (managed by the Mental Health Foundation CPB) in its first two years of admission to the mental health centre and being able to define improvement aspects on users. Material and Method: From an initial sample of 88 residents (admitted during the years 2009-2011). Comparing the variations during the required time of psychiatric admission, use of community rehabilitation resources, clinical stability, performing ADLs and quality of life (social and personal), taking as values the collected information during the year preceding their incorporation into the residence and the two years of relationship. Results: We could affirm that staying at residences favours users’ clinical stability, reducing the number of admissions and their length of stay. The resident improves in ADLs functioning, health habits and personal relationships, regaining his citizen ship status, more active and self-sufficient. The improvement in social and occupational residents adjustment is reflected in the increasing of rehabilitation resources used and a greater participation in community life (both inside and outside the residence) (AU)

Validación de la Escala de valoración de los Niveles de Atención Residencial, para personas con Trastorno Mental Severo (ENAR-CPB) / Validation of Scale for the Assessment of Residential Attention Levels, for people with Severe Mental Disorder (ENAR-CPB)

Introducción: En Cataluña se están creando, desde el año 2000, residencias para personas con trastornos de salud mental como un servicio de la Administración pública. Tras casi una década de funcionamiento se dispone ya de una evidencia acumulada sobre la utilidad de las residencias en la mejora de la rehabilitación de personas con Trastorno Mental Grave (TMG). El objetivo del presente trabajo es presentar la escala elaborada para medir el tipo de necesidades de atención que precisan los usuarios de programas residenciales para personas con TMG Método: Tras realizar una búsqueda sistemática de diferentes escalas validadas se objetivó la necesidad de definir una nueva escala más específica para poder valorar los niveles de atención en el colectivo de usuarios beneficiarios del programa residencial. El instrumento final consta de una total de 24 ítems, formulados como enunciados, con 5 posibles respuestas, que se valoran de 0 a 4 (de menor a mayor necesidad de atención). Los ítems están agrupados en 6 apartados, de 4 preguntas cada uno: 1. Dimensión física, 2. Dimensión clínica, 3. AVD (Actividades de la Vida Diaria), 4. Autonomía y autogobierno, 5. Relaciones interpersonales y 6. Bienestar personal e integración en el entorno. La escala es complementada por parte de los profesionales del centro, a partir de la observación estructurada y conocimiento del usuario. Una vez definida la Escala en su totalidad, se realizó una primera evaluación a los 44 residentes en activo, durante los meses de mayo y junio de 2007 y una segunda 9 meses después, en enero y febrero de 2008. Los datos obtenidos se analizaron mediante el paquete estadístico SPSS y se realizaron los siguientes análisis: estudio de validez interna (estructura factorial) a través de un analisis de componentes principales, estimación de la consistencia interna a través del coeficiente α de Cronbach, fiabilidad entre evaluadores mediante el coeficiente de correlación interclase, sensibilidad al cambio comparando las puntuaciones basales y en una segunda evaluación trascurrido 9 meses. Resultados: La Escala ENAR-CPB presenta una muy buena consistencia interna (alfa de Cronbach 0,916). Con un test-retest en el tiempo (basal y a los 3 años) de correlación 0,810, y un correlación Interevaluadores de 0,938. El análisis factorial identificó cuatro factores que explican una varianza total del 62,89 %. Conclusiones: La Escala ENAR-CPB muestra un muy buen comportamiento, tanto en el grado de consistencia interna, como en la correlación entre variables, entre evaluadores y en la correlación test-retes entre el valor basal y a los 3 años; siendo una escala aceptable como elemento de medida para definir el nivel de necesidad de atención que precisan los usuarios de residencias para personas con TMG y su evolución(AU)

Introduction: Since the year 2000 residences for people with mental disorders have been created in Catalonia as a service of public Administration. After operating for almost a decade evidence has finally become available about the usefulness of these residences in improving the rehabilitation of people with SMD (Severe Mental Disorder). The work consists to present a specific scale to assess the levels of attention/dependency of those who live in these residences that have TMS, and to monitor their progress. Method: After systematically searching for different validated scales and testing some of them, it was decided that a new, more specific scale was needed to evaluate the levels of attention amongst those who live in the residences. A total of 24 items were defined, four for each of the six dimensions, with values between 0 and 4 (0 being lower and 4 being higher need of attention). Taking into consideration six dimensions (1.physical dimension, 2.clinical dimension, 3.AVD, 4.autonomy and self-governance, 5. interpersonal relations and 6. personal well-being and integration in the environment), through structured retrospective observation, by the professionals of the centre. Once the Scale is completely defined, it is filled out by 44 active residents, during the months of May and June 2007. It is filled out once again 9 months later, in January and February 2008. The obtained data was analysed with the statistics pack SPSS and the following analyses were made: internal validity study (factor structure) through an analysis of main components, estimation of internal consistency through the Cronbach de un análisis de componentes principales, estimación de la consistencia interna a través del coeficiente a de Cronbach,a coefficient, evaluator reliability with the interclass correlation coefficient, sensitivity to change comparing base scores with those of Scales filled out 9 months later. Results: The ENAR-CPB scale presents very good internal consistency (Cronbach alpha of 0,916). With a correlation time test-retest (base and 3 years later) of 0,810, and a Interraiter between evaluators of 0,938. Factorial analysis identified four factors that explain a total variance of 62,89 %. Conclusions: The ENAR-CPB Scale performs well, both in terms of internal consistency as well as in the correlation between variables, evaluators and test-retest, 3 years later; it is acceptable as a measuring element for defining the level of attention needed by those who live in residences that have TMS, as well as being useful for monitoring their progress(AU)