Trends and challenges in microfluidic methods for protein manipulation-A review.

Proteins are important molecules involved in an immensely large number of biological processes. Being capable of manipulating proteins is critical for developing reliable and affordable techniques to analyze and/or detect them. Such techniques would enable the production of therapeutic agents for the treatment of diseases or other biotechnological applications (e.g., bioreactors or biocatalysis). Microfluidic technology represents a potential solution to protein manipulation challenges because of the diverse phenomena that can be exploited to achieve micro- and nanoparticle manipulation. In this review, we discuss recent contributions made in the field of protein manipulation in microfluidic systems using different physicochemical principles and techniques, some of which are miniaturized versions of already established macro-scale techniques.

Complications associated with the use of radial arterial catheters in relation to their length: Does size matter?

BACKGROUND: Radial arterial catheters (RAC) are commonly used in emergency services and intensive care units (ICU) for continuous invasive monitoring of blood pressure and arterial blood gas sampling. Complications associated with RAC are rare. Regarding length of RAC catheters and complications, few studies were found in the literature. The present study seeks to provide health care professionals with scientific evidence to select an optimal length of RAC, based on the difference in the incidence of complications between ultrasound-guided catheters of the same diameter but different lengths. METHODS: Observational, descriptive, retrospective study. Patients older than 17 years admitted to the emergency department or ICU were included. RAC were placed with diameters of 20 gauge, between 5 and 8 cm (Arrow-Teleflex), and 22 gauge diameters between 4 and 8 cm (Vygon). Univariate analysis was made to determine behavior of the numerical variables. Normality of variables was determined through a Shapiro-Wilk-test. Qualitative variables were expressed in percentages, quantitative variables in means and standard deviation, or with median and quartiles in the case of a non-normal distribution. Chi-square or Fisher method was used for qualitative variables and the t-test for symmetric quantitative variables. Asymmetric distributions were processed with the Mann-Whitney U test. A value p < 0.05 was considered statistically significant. The statistical analysis was performed with Stata 14.1 program. RESULTS: About 793 RAC were placed between 2016 and 2019 were included, median age was 60 (37-73) (RIQ) years, 49% male. Complications were reported in all groups on average 17.5%, the most frequent being dysfunction/occlusion of the catheter. Given complications of the same diameter and different catheter lengths, there were no statistical differences between groups. CONCLUSION: Selecting one length or another with a catheter of the same diameter does not have statistically significant differences, in terms of the complications this device may cause-meaning that size does not matter.

Caracterización clínica de la peritonitis secundaria en una institución de tercer nivel y factores relacionados con mortalidad / Clinical characterization of secondary peritonitis in a tertiary level of care institution and factors related to mortality

Introducción. La peritonitis secundaria es una enfermedad con altos índices de mortalidad, por lo que se considera de gran importancia identificar los factores que inciden en ella. Método. Se realizó un estudio analítico entre 2019 y 2020 en el que se incluyeron pacientes con peritonitis secundaria, se caracterizaron las variables más relacionadas con el pronóstico, como aspectos demográficos y clínicos, y se analizó la asociación entre la mortalidad y estas variables. Resultados. La mortalidad hospitalaria fue del 30,7 %, encontrando como condiciones relacionadas con la mortalidad la ubicación de la fuente séptica en abdomen superior, la presencia de dolor en abdomen superior, atención en UCI, control del foco en la primera intervención, pacientes que cursaron con falla renal, edad del paciente y valores de hemoglobina. Conclusiones. En la cohorte estudiada se encontraron índices de mortalidad dos veces superiores a los reportados en Suramérica y 1,5 veces a los del resto del país. El mayor poder predictivo de mortalidad en el análisis bivariado fue dado por la presencia de falla renal y el valor de la hemoglobina.

Introduction. Secondary peritonitis is a disease with high mortality rates, so it is considered of great importance to identify the factors that affect it. Methods. An analytical study was carried out between 2019 and 2020 in which patients with secondary peritonitis were included, the variables most related to prognosis were characterized, such as demographic and clinical aspects, and the association between mortality and these variables was analyzed. Results. Hospital mortality was 30.7%, finding conditions related to mortality to be the location of the septic source in the upper abdomen, the presence of pain in the upper abdomen, care in the ICU, control of the focus in the first intervention, patients who underwent kidney failure, patient age, and hemoglobin values. Conclusion. Mortality rates were found in the studied cohort twice higher than those reported in South America and 1.5 times higher than those of the rest of the country. The greatest predictive power of mortality in the bivariate analysis was given by the presence of kidney failure and hemoglobin.

Guillain-Barré syndrome in a COVID-19 patient / Síndrome de Guillain-Barré en paciente con COVID-19

Abstract Coronavirus type 2 is a P-coronavirus whose infection is characterized by a predominantly respiratory clinical picture. However, neurological symptoms are garnering great interest related to pulmonary infection and direct viral invasion of the central nervous system, with a possible association between Guillain-Barré syndrome and SARS-CoV-2 infection. This report describes this relationship in a 44-year-old female patient with classical Guillain-Barré syndrome signs and symptoms on admission, and respiratory signs and symptoms six days prior to the onset of neurological symptoms. There were positive SARS-CoV IgG and IgM blood tests and an epidemiological link of direct contact with people infected with SARS-CoV-2. She required ICU care due to the risk of respiratory failure, along with immunoglobulin treatment, but did not need mechanical ventilation; she improved and was discharged. One month later she consulted again and was thought to have had a Guillain-Barré relapse. She was hospitalized and treated until she progressed and her symptoms resolved. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2204).

Resumen El coronavirus tipo 2 es un P-coronavirus cuya infección se caracteriza por clínica de predominio respiratorio; sin embargo, la sintomatologia neurológica está cobrando gran interés asociada a la infección pulmonar e invasión directa del virus al sistema nervioso central. Siendo posible la aso ciación entre el síndrome de Guillain-Barré y la infección por virus SARS-CoV-2. En este reporte se describe dicha asociación en una paciente femenina de 44 años de edad, con clínica clásica de síndrome de Guillain-Barré al ingreso y clínica respiratoria seis días previos a la instalación de los síntomas neurológicos. Reportándose serologías IgG e IgM para SARS-CoV-positivas y nexo epidemiológico de contacto directo con personas infectadas por SARS-CoV-2. Requirió manejo en UCI por riesgo de falla respiratoria, manejo con inmunoglobulinas, sin requerimiento de ventilación mecánica, presentando mejoría y otorgándose salida. Un mes después reconsulta, se considera recaída de Guillain-Barré, se hospitaliza, se inicia manejo hasta evolución y resolución de síntomas. (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2204).