Sulfato de magnesio y aminofilina en el tratamiento de niños, niñas y adolescentes hospitalizados. Perfil de uso y respuesta terapéutica

Introducción: Sulfato de magnesio (MgSO4) y aminofilina son broncodilatadores intravenosos utilizados en el tratamiento de niños con broncoobstrucción (BO). La evidencia disponible para recomendar su uso es escasa. Objetivo: Caracterizar el perfil de uso y la respuesta terapéutica al MgSO4 y aminofilina en el tratamiento de la BO en niños hospitalizados en un centro de referencia de Uruguay. Materiales y métodos: Estudio descriptivo de corte transversal mediante revisión de historias y entrevistas. Se incluyeron a todos los menores de 15 años que utilizaron estos fármacos. Se evaluó la respuesta terapéutica a la administración de ambos fármacos en forma exclusiva y concomitante y la presencia de efectos adversos. Resultados: Se incluyeron 102 niños, mediana de edad 4 años, ≤5 años 62%. Los principales diagnósticos fueron: crisis asmática 56% y neumonía viral 31%. Recibieron ambos fármacos 48%, únicamente aminofilina 28% y exclusiva de MgSO4 24%. Se observó buena respuesta terapéutica a la administración: exclusiva de MgSO4 67%, consecutiva de MgSO4 y aminofilina 45% y exclusiva de aminofilina en 34%. En 38,2% se registró al menos un efecto adverso, 64% eran menores de 5 años, riesgo aumentado en 1,5 veces. Conclusiones: Se registraron variadas indicaciones, la mayoría en niños asmáticos y en un porcentaje menor indicaciones fuera de prospecto. Menos de la mitad presentaron buena respuesta luego de la administración de MgSO4 y/o aminofilina. En un porcentaje no despreciable se registraron efectos adversos, predominaron en menores de 5 años. Son necesarios nuevos estudios para continuar caracterizando el perfil de uso y seguridad de estos fármacos.

Introduction: Magnesium sulfate (MgSO4) and aminophylline are intravenous bronchodilators used in the treatment of children with bronchoobstruction (BO). The evidence available to recommend their use is scarce. Objective: To characterize the use profile and therapeutic response to MgSO4 and aminophylline in the treatment of BO in children hospitalized in a reference center in Uruguay. Materials and methods: This was a descriptive cross-sectional study through review of clinical histories and interviews. All children under 15 years of age who used these drugs were included. The therapeutic response to the administration of both drugs exclusively and concomitantly and the presence of adverse effects were evaluated. Results: 102 children were included, median age was 4 years, 62% were ≤5 years. The main diagnoses were: asthmatic crisis, 56% and viral pneumonia, 31%. 48% received both drugs, 28% only aminophylline and 24% exclusively MgSO4. Good therapeutic response was observed to the administration: MgSO4 exclusively, 67%, MgSO4 followed by aminophylline, 45% and aminophylline exclusively in 34%. At least one adverse effect was recorded in 38.2%, of these, 64% were under 5 years of age, risk increased by 1.5 times. Conclusions: Various indications were recorded, the majority in asthmatic children and a smaller percentage off-label indications. Less than half had a good response after the administration of MgSO4 and/or aminophylline. Adverse effects were recorded in a non-negligible percentage, predominating in children under 5 years of age. New studies are necessary to continue characterizing the use and safety profile of these drugs.

Distal Rotational Metatarsal Osteotomy (DROMO) for the treatment of hallux valgus associated with first metatarsal pronation: Surgical technique and initial results.

BACKGROUND: Hallux valgus (HV) is a very common deformity worldwide. Most of the surgical techniques used in the treatment of HV only correct these deformities in two planes, that is sagittal and transverse planes. The importance of the first metatarsal pronation as an etiological factor of hallux valgus is validated by numerous authors and it is usually unaddressed. Few surgical techniques have focused on the correction of rotational deformity of the hallux valgus. We aim to first report a detailed technique and a case series using the Distal Rotational Metatarsal Osteotomy (DROMO) surgical technique, which is less invasive and can address the pronation deformation. METHODS: The inclusion period was 6 months finishing in April 2021. The study analyzed the following x-ray parameters: preoperative and postoperative intermetatarsal angle (IMA), preoperative and postoperative hallux valgus angle (HVA), preoperative and postoperative coronal rotation of the first metatarsal according Hardy and Clapham's classification as described by Kim et al., preoperative and postoperative shape of the first metatarsal head as described by Ono et al. RESULTS: 33 patients matched our inclusion and exclusion criteria. Most patients underwent the surgery for the left foot (n = 18), compared to the right foot (n = 15). We found statistically significant differences between preoperative and postoperative IMA (p < 0.001), preoperative and postoperative HVA (p < 0.001). Preoperative and postoperative coronal rotation of the first metatarsal as classified by Hardy and Clapham was significantly different (p < 0.001), as well as preoperative and postoperative shape of the first metatarsal head (p < 0.01). CONCLUSIONS: DROMO can correct the metatarsal rotation through minimal invasive surgery. From our perspective, DROMO technique should be another alternative for HV correction technique which in time can be associated as a local anesthetic technique, DROMO results are attractive for an ambulatory procedure.

Sandwich Immuno-RCA Assay with Single Molecule Counting Readout: The Importance of Biointerface Design.

The analysis of low-abundance protein molecules in human serum is reported based on counting of the individual affinity-captured analyte on a solid sensor surface, yielding a readout format similar to digital assays. In this approach, a sandwich immunoassay with rolling circle amplification (RCA) is used for single molecule detection (SMD) through associating the target analyte with spatially distinct bright spots observed by fluorescence microscopy. The unspecific interaction of the target analyte and other immunoassay constituents with the sensor surface is of particular interest in this work, as it ultimately limits the performance of this assay. It is minimized by the design of the respective biointerface and thiol self-assembled monolayer with oligoethylene (OEG) head groups, and a poly[oligo(ethylene glycol) methacrylate] (pHOEGMA) antifouling polymer brush was used for the immobilization of the capture antibody (cAb) on the sensor surface. The assay relying on fluorescent postlabeling of long single-stranded DNA that are grafted from the detection antibody (dAb) by RCA was established with the help of combined surface plasmon resonance and surface plasmon-enhanced fluorescence monitoring of reaction kinetics. These techniques were employed for in situ measurements of conjugating of cAb to the sensor surface, tagging of short single-stranded DNA to dAb, affinity capture of the target analyte from the analyzed liquid sample, and the fluorescence readout of the RCA product. Through mitigation of adsorption of nontarget molecules on the sensor surface by tailoring of the antifouling biointerface, optimizing conjugation chemistry, and by implementing weak Coulombic repelling between dAb and the sensor surface, the limit of detection (LOD) of the assay was substantially improved. For the chosen interleukin-6 biomarker, SMD assay with LOD at a concentration of 4.3 fM was achieved for model (spiked) samples, and validation of the ability of detection of standard human serum samples is demonstrated.

[Public conversation on vaccines during the covid-19 pandemic in Argentina, 2021-2022]. / Conversación pública sobre vacunas en la pandemia de covid-19 en Argentina, 2021-2022.

In the face of declining vaccination coverage and the dissemination of health-related information, conversations in the public/mediatic digital sphere constitute a relevant study area for the field of health communication. Through a qualitative study based on the analysis of government publications, digital press, and social media, we characterize the public conversation on vaccines - in terms of topics, moments, axes, and framings in Argentina during the 2020-2021 period - marked by the debate on covid-19 vaccines. The results show that public conversation focused on covid-19 vaccination, structured in two distinct moments (vaccine production and vaccination campaign), and under moral framings grounded in vaccination as a care practice and science as an authoritative voice. Simultaneously, doubts about the safety and efficacy of vaccines shaped arguments of vaccine hesitancy, which we understand as part of extended practices associated with distrust towards institutions and reinterpretations of scientific knowledge and care.

Ante la caída de las coberturas vacunales y la circulación informativa sobre salud, las conversaciones en el entorno público/mediático digital constituyen un ámbito de estudio relevante para el campo de la comunicación en salud. A través de un estudio cualitativo, basado en el análisis de publicaciones del gobierno, la prensa digital y las redes sociales, caracterizamos la conversación pública sobre vacunas ­en términos de temas, momentos, ejes y encuadres en Argentina en el período 2020-2021­ signada por el debate sobre las vacunas covid-19. Los resultados muestran que la conversación pública se centralizó en la vacunación contra el covid-19, se estructuró en dos momentos diferenciados (producción de vacunas y campaña de vacunación) y bajo encuadres morales sustentados en la vacunación como práctica de cuidado y la ciencia como voz autorizada. En simultáneo, las dudas sobre la seguridad y eficacia de las vacunas estructuraron argumentos de reticencia vacunal, que entendemos como parte de prácticas extendidas, asociadas con las desconfianzas hacia las instituciones y reinterpretaciones del conocimiento científico y del cuidado.

Mass-Spectrometric Identification of Proteins and Pathways Responsible for Fouling on Poly(ethylene glycol) Methacrylate Polymer Brushes.

Prevention of fouling from proteins in blood plasma attracts significant efforts, and great progress is made in identifying surface coatings that display antifouling properties. In particular, poly(ethylene glycol) (PEG) is widely used and dense PEG-like cylindrical brushes of poly[oligo(ethylene glycol) methacrylate] (poly(OEGMA)) can drastically reduce blood plasma fouling. Herein, a comprehensive study of the variation of blood plasma fouling on this surface, including the analysis of the composition of protein deposits on poly(OEGMA) coatings after contact with blood plasma from many different donors, is reported. Correlation between the plasma fouling behavior and protein deposit composition points to the activation of the complement system as the main culprit of dramatically increased and accelerated deposition of blood plasma proteins on this type of antifouling coating, specifically through the classical pathway. These findings are consistent with observations on PEGylated drug carriers and highlight the importance of understanding the potential interactions between antifouling coatings and their environment.

Response to sorafenib in a locally advanced oncocytic cell carcinoma of the thyroid.

We present the case of a female patient in her late 70s, diagnosed with widely invasive oncocytic cell carcinoma, with extrathyroidal extension, infiltration into the extrathyroidal muscle, involvement of the sternohyoid muscle and infiltration into the external muscle fibres of the oesophagus. Over the following year, metastases were documented in the lungs, bones and brain. Additionally, there was progression of the locally advanced lesion involving the airway and upper gastrointestinal tract. After considering iodine refractoriness, treatment with sorafenib was initiated. Notably, regression of the locoregional lesion at the cervical level was observed following treatment with the multikinase inhibitor.

Conversación pública sobre vacunas en la pandemia de covid-19 en Argentina, 2021-2022 / Public conversation on vaccines during the covid-19 pandemic in Argentina, 2021-2022

RESUMEN Ante la caída de las coberturas vacunales y la circulación informativa sobre salud, las conversaciones en el entorno público/mediático digital constituyen un ámbito de estudio relevante para el campo de la comunicación en salud. A través de un estudio cualitativo, basado en el análisis de publicaciones del gobierno, la prensa digital y las redes sociales, caracterizamos la conversación pública sobre vacunas -en términos de temas, momentos, ejes y encuadres en Argentina en el período 2020-2021- signada por el debate sobre las vacunas covid-19. Los resultados muestran que la conversación pública se centralizó en la vacunación contra el covid-19, se estructuró en dos momentos diferenciados (producción de vacunas y campaña de vacunación) y bajo encuadres morales sustentados en la vacunación como práctica de cuidado y la ciencia como voz autorizada. En simultáneo, las dudas sobre la seguridad y eficacia de las vacunas estructuraron argumentos de reticencia vacunal, que entendemos como parte de prácticas extendidas, asociadas con las desconfianzas hacia las instituciones y reinterpretaciones del conocimiento científico y del cuidado.

ABSTRACT In the face of declining vaccination coverage and the dissemination of health-related information, conversations in the public/mediatic digital sphere constitute a relevant study area for the field of health communication. Through a qualitative study based on the analysis of government publications, digital press, and social media, we characterize the public conversation on vaccines - in terms of topics, moments, axes, and framings in Argentina during the 2020-2021 period - marked by the debate on covid-19 vaccines. The results show that public conversation focused on covid-19 vaccination, structured in two distinct moments (vaccine production and vaccination campaign), and under moral framings grounded in vaccination as a care practice and science as an authoritative voice. Simultaneously, doubts about the safety and efficacy of vaccines shaped arguments of vaccine hesitancy, which we understand as part of extended practices associated with distrust towards institutions and reinterpretations of scientific knowledge and care.

Seroprevalence and coprological prevalence of liver fluke Fasciola hepatica in cattle and sheep from Santander department, Colombia.

Fasciola hepatica is a parasite with a worldwide distribution that affects several mammals, including humans, and is considered a public health problem. Therefore, the aim of this study was to determine the prevalence of Fasciola hepatica in humans, cattle and sheep, as well as to evaluate factors associated with the prevalence. A total of 185 serum samples from sheep, 290 from cattle, and 114 from humans were collected and processed using an in-house developed ELISA to detect IgG antibodies against F. hepatica. Additionally, 185 stool samples from sheep and 290 from cattle were examined using a Dennis sedimentation technique. Risk factors were analyzed using epidemiological surveys. The overall seroprevalence was 46.5% (86/185) in sheep, 32.5% (94/289) in cattle, and no humans tested positive for the infection. The coprological prevalence was 47.7% (86/180) in sheep and 33.7% (98/290) in cattle. Female gender and cattle living with alternate grazing management showed 2.5 and 6.5 times higher probability of infection, respectively. Bovines coexisting with sheep exhibited a higher risk of infection (odds ratio [OR]=4.3) compared to those without sheep. We concluded that F. hepatica in cattle and sheep has an endemic behavior, and therefore represents a problem of public health for rural communities.

[Research ethics committees in the Autonomous City of Buenos Aires: 14 years after the implementation of Law 3301.] / Los comités de ética de investigación en la Ciudad Autónoma de Buenos Aires: a catorce años de la implementación de la Ley 3301.

This article analyzes the implementation of research ethics committees in the Autonomous City of Buenos Aires, a process that took place in the context of a historical process of implementing health research policies at both the national and jurisdictional levels. Employing a qualitative, observational, and cross-sectional approach, we gathered secondary sources of public information and conducted semi-structured, in-depth interviews with members of the committees in the Autonomous City of Buenos Aires. The results are presented in relation to three aspects: 1) the composition of the research ethics committees; 2) work processes, emphasizing the impact of the COVID-19 pandemic; and 3) obstacles and proposals, that focuses on improvements identified by committee members.

El presente artículo se propone analizar el proceso de implementación de los comités de ética en investigación en la Ciudad Autónoma de Buenos Aires, cuya conformación se observa en el marco de un proceso histórico de implementación de políticas de investigación en salud a nivel nacional y jurisdiccional. Desde un enfoque de investigación cualitativo, observacional y de corte transversal, se realizó un relevamiento de fuentes secundarias de información pública, y entrevistas semiestructuradas y en profundidad a integrantes de los comités de la Ciudad Autónoma de Buenos Aires. Los resultados se presentan agrupados en tres ejes: 1) la conformación de los comités de ética en investigación; 2) procesos de trabajo, haciendo hincapié en el impacto de la pandemia de covid-19; y 3) obstáculos y propuestas, que se focaliza en las mejoras identificadas por sus integrantes.

On-Demand Cell Sheet Release with Low Density Peptide-Functionalized Non-LCST Polymer Brushes.

Cell sheet harvesting offers a great potential for the development of new therapies for regenerative medicine. For cells to adhere onto surfaces, proliferate, and to be released on demand, thermoresponsive polymeric coatings are generally considered to be required. Herein, an alternative approach for the cell sheet harvesting and rapid release on demand is reported, circumventing the use of thermoresponsive materials. This approach is based on the end-group biofunctionalization of non-thermoresponsive and antifouling poly(2-hydroxyethyl methacrylate) (p(HEMA)) brushes with cell-adhesive peptide motifs. While the nonfunctionalized p(HEMA) surfaces are cell-repellant, ligation of cell-signaling ligand enables extensive attachment and proliferation of NIH 3T3 fibroblasts until the formation of a confluent cell layer. Remarkably, the formed cell sheets can be released from the surfaces by gentle rinsing with cell-culture medium. The release of the cells is found to be facilitated by low surface density of cell-adhesive peptides, as confirmed by X-ray photoelectron spectroscopy. Additionally, the developed system affords possibility for repeated cell seeding, proliferation, and release on previously used substrates without any additional pretreatment steps. This new approach represents an alternative to thermally triggered cell-sheet harvesting platforms, offering possibility of capture and proliferation of various rare cell lines via appropriate selection of the cell-adhesive ligand.

Los comités de ética de investigación en la Ciudad Autónoma de Buenos Aires: a catorce años de la implementación de la Ley 3301 / Research ethics committees in the Autonomous City of Buenos Aires: 14 years after the implementation of Law 3301

RESUMEN El presente artículo se propone analizar el proceso de implementación de los comités de ética en investigación en la Ciudad Autónoma de Buenos Aires, cuya conformación se observa en el marco de un proceso histórico de implementación de políticas de investigación en salud a nivel nacional y jurisdiccional. Desde un enfoque de investigación cualitativo, observacional y de corte transversal, se realizó un relevamiento de fuentes secundarias de información pública, y entrevistas semiestructuradas y en profundidad a integrantes de los comités de la Ciudad Autónoma de Buenos Aires. Los resultados se presentan agrupados en tres ejes: 1) la conformación de los comités de ética en investigación; 2) procesos de trabajo, haciendo hincapié en el impacto de la pandemia de covid-19; y 3) obstáculos y propuestas, que se focaliza en las mejoras identificadas por sus integrantes.

ABSTRACT This article analyzes the implementation of research ethics committees in the Autonomous City of Buenos Aires, a process that took place in the context of a historical process of implementing health research policies at both the national and jurisdictional levels. Employing a qualitative, observational, and cross-sectional approach, we gathered secondary sources of public information and conducted semi-structured, in-depth interviews with members of the committees in the Autonomous City of Buenos Aires. The results are presented in relation to three aspects: 1) the composition of the research ethics committees; 2) work processes, emphasizing the impact of the COVID-19 pandemic; and 3) obstacles and proposals, that focuses on improvements identified by committee members.

[Tensions between social acceptance and individual reticence to COVID-19 vaccination: the perspective of fathers and mothers residing in the Autonomous City of Buenos Aires in the context of the COVID-19 pandemic]. / Tensiones entre la aceptación social y la reticencia individual a la vacunación: la perspectiva de padres y madres que residen en la Ciudad Autónoma de Buenos Aires en contexto de pandemia por COVID-19.

The decline in vaccination coverage associated with the population's mistrust of vaccines has been defined as a global health threat. Adopting a qualitative approach centered on the social significance of vaccines, we conducted semi-structured interviews with mothers and fathers in the City of Buenos Aires between July and December 2020. We describe and analyze their knowledge and the arguments used to justify their acceptance or reluctance to vaccinate their children in the context of COVID-19. The results show that the studied population possesses knowledge about vaccines and accepts them as a preventive practice. Nonetheless, it was possible to identify a broad spectrum of attitudes towards vaccination, including more reticent positions based on concerns regarding their safety, adverse effects, and the need to apply them for eradicated diseases, proposing vaccination as an optional and complementary practice to other care practices. Arguments are organized under the assumption of individual and moral responsibility for health care, an expression of the current sociocultural and health backdrop.

La caída en las coberturas de vacunación asociada a la desconfianza de la población hacia las vacunas ha sido definida como una amenaza para la salud a nivel global. A través de un enfoque cualitativo centrado en la significación social de las vacunas, se realizaron entrevistas semiestructuradas a madres y padres de la Ciudad Autónoma de Buenos Aires, entre julio y diciembre de 2020. Describimos y analizamos sus conocimientos y los argumentos esgrimidos para justificar su aceptación o reticencia a la vacunación de sus hijas e hijos en el contexto del COVID-19. Los resultados muestran que la población estudiada maneja conocimientos sobre las vacunas y las acepta como práctica preventiva. A su vez, reconstruimos un amplio espectro en el que identificamos actitudes reticentes a la vacunación, basadas en dudas sobre su seguridad, efectos adversos y la necesidad de aplicarlas para enfermedades erradicadas, proponiendo la vacunación como práctica opcional y complementaria a otras prácticas de cuidado. Los argumentos se organizan bajo el supuesto de la responsabilidad individual y moral sobre el cuidado de la salud, expresión del actual escenario sociocultural y sanitario.

Assessment of livestock greenhouse gases in Colombia between 1995 and 2015.

The livestock sector in Colombia significantly participates in national economic dynamics but makes significant worldwide contributions to greenhouse gas emissions. Hence, climate change mitigation in this sector is essential. This study aims to assess the greenhouse gas in the livestock sector. The results are reported in methane emissions (CH4) and nitrous oxide (N2O) from enteric fermentation, and N2O by manure management based on the information from the Emission Database for Global Atmospheric Research (EDGAR), in all cases expressed as dioxide of carbon (CO2eq). The emissions obtained from the EDGAR database for 2015 were proportional to the values of the National Inventory of Greenhouse Gases published by the Institute of Hydrology, Meteorology, and Environmental Studies (IDEAM) in 2016. Colombia is the 12th on global, 4th in America and 2nd in South America position by livestock GHG emission, and is the dominant source in all economic sector. The results showed higher records for CH4 emissions during the years 2010 and 2015, while the N2O emissions were higher during 2015. The regions with the highest emissions of CH4 and N2O corresponded to the northwestern area of Colombia. The Spearman correlation test showed a positive correlation between the CH4 emissions, and the age groups studied. The post hoc analysis of the Kruskal-Wallis test showed a more significant influence on CH4 emissions.

Tuberculosis en grandes conglomerados urbanos: sentidos y prácticas de abordaje de los equipos de una red de servicios públicos de la Ciudad de Buenos Aires, Argentina

Introducción: la tuberculosis (TB) persiste como un importante problema de salud pública en Argentina con una concentración preocupante en grandes centros urbanos. El objetivo de este estudio es la recuperación de los sentidos y las prácticas del proceso de atención-cuidado de la TB por parte de profesionales en una red pública de servicios de salud de un gran conglomerado urbano. Metodología: se realizó un análisis exploratorio con enfoque cualitativo, a partir de entrevistas semiestructuradas a integrantes de equipos sanitarios en un hospital y en centros de salud de la Ciudad Autónoma de Buenos Aires (CABA). Resultados: se identificaron diferentes matices de sentido acerca de la complejidad en el abordaje de la TB, estos variaban de acuerdo con las características de los servicios y las personas con TB. Se describieron estrategias para el tratamiento de casos difíciles: disponer de equipos interdisciplinarios, involucrar a otros actores de salud y dialogar con organizaciones de la sociedad civil bajo un enfoque territorial. Conclusiones: el control de la problemática de la TB en los grandes conglomerados urbanos presenta amplios desafíos. Desde la perspectiva del personal sanitario, se observan coyunturas que requieren la adecuación de ciertas estrategias interventoras para dar una respuesta de manera integrada.

Introduction: Tuberculosis (TB) persists as an important public health problem in Argentina with a worrying concentration in large urban centers. The objective of this study is to recover the meanings and practices of professionals from a public network of health services in a large urban conglomerate on the TB care-care process. Methods: An exploratory study with a qualitative approach was carried out, based on semi-structured interviews with members of the health teams of a hospital and health centers of the CABA. Results: It was identified that, from the perspective of the health teams, there are different nuances of meaning about the complexity of the TB approach. These varied according to the characteristics of the services in which they were inserted and of the people with TB. Strategies for dealing with complex cases were described: having interdisciplinary teams, acting together with other health effectors and dialoguing with civil society organizations under a territorial approach. Conclusion: The control of the TB problem in large urban conglomerates presents extensive challenges. From the perspective of health teams, complex situations are observed that require the development of certain strategies to address them. These allow the adaptation of interventions to provide an integrated response.

Itinerarios de tratamiento según las narrativas de madres y padres de niños y niñas con discapacidad secundaria a trastornos del neurodesarrollo / Therapeutic itineraries according to the narratives of parents of children with disabilities secondary to neurodevelopmental disorders

Introducción. Los trastornos en el neurodesarrolloinfantil constituyen un 10 % de las causasde discapacidad en la niñez. La búsquedade atención médica configura itinerariosterapéuticos, entendidos como los procesos de búsqueda y atención para el cuidado de la salud, donde surgen oportunidades de diagnósticoy tratamiento. El objetivo fue explorar dichos itinerarios para comprender las oportunidades y barreras que se presentan para instaurarterapias y pautas de crianza que promuevan el neurodesarrollo. Población y métodos. Estudio cualitativomediante entrevistas en profundidad a madres y padres de niños (de junio de 2018 a noviembre de 2019). El análisis se realizó sobre la base del modelo social de la discapacidad y del de desarrollo infantil propuesto por Vygotsky. Resultados. Se realizaron 16 entrevistas.Considerando la edad de inicio de los itinerarios terapéuticos y el diagnóstico, se identificaron dos grupos: aquellos que los comenzaron desde el nacimiento hasta los 2 años (inicio precoz) y quienes lo hicieron a partir de los 3 años (inicio en la primera infancia e infancia tardía). En el primero se habilita tempranamente la búsqueda de tratamiento, mientras que en el segundo se prolongaron en el tiempo las decisiones sobre el inicio y/o el tipo de terapias. El inicio tardío se acompañó de dificultades en la escuela, períodosde incertidumbre, angustia y/o conflictosfamiliares por las complejidades de la crianza. Conclusiones. Los itinerarios terapéuticos seiniciaron en forma precoz en algunos casos y tardía en otros. El inicio de tratamientos permitióincorporar herramientas para acortar la brecha de incongruencia entre las líneas biológica y cultural de desarrollo.

Introduction. Childhood neurodevelopmental disorders account for 10% of the causes of childhood disability. The search for medical care leads to therapeutic itineraries routes taken by individuals to seek health care where diagnostic and treatment opportunities arise. Our objective was to explore these itineraries in order to understand the opportunities and barriers to the implementation of therapies and child rearing patterns promoting neurodevelopment. Population and methods. Qualitative study using in-depth interviews with children's parents (between June 2018 and November 2019). The analysis was based on the social model of disability and Vygotsky's approach to child development. Results. A total of 16 interviews were conducted. Considering the time of diagnosis and the age when the therapeutic itinerary started, 2 groups were identified: those who started from birth to 2 years old (early initiation) and those who started from 3 years old (late childhood initiation). In the first group, the search for treatment starts at an early stage, while in the other group, decisions on the initiation and/or type of treatments are prolonged over time. Late initiation was accompanied by difficulties in school, periods of uncertainty, distress and/or family conflicts due to the complexities of parenting. Conclusions. Therapeutic itineraries started early in some cases and at a later stage in others. The initiation of treatments made it possible to use tools to bridge the gap of discrepancies between the biological and cultural lines of development.

Therapeutic itineraries according to the narratives of parents of children with disabilities secondary to neurodevelopmental disorders. / Itinerarios de tratamiento según las narrativas de madres y padres de niños y niñas con discapacidad secundaria a trastornos del neurodesarrollo.

INTRODUCTION: Childhood neurodevelopmental disorders account for 10% of the causes of childhood disability. The search for medical care leads to therapeutic itineraries routes taken by individuals to seek health care where diagnostic and treatment opportunities arise. Our objective was to explore these itineraries in order to understand the opportunities and barriers to the implementation of therapies and child rearing patterns promoting neurodevelopment. POPULATION AND METHODS: Qualitative study using in-depth interviews with children's parents (between June 2018 and November 2019). The analysis was based on the social model of disability and Vygotsky's approach to child development. RESULTS: A total of 16 interviews were conducted. Considering the time of diagnosis and the age when the therapeutic itinerary started, 2 groups were identified: those who started from birth to 2 years old (early initiation) and those who started from 3 years old (late childhood initiation). In the first group, the search for treatment starts at an early stage, while in the other group, decisions on the initiation and/or type of treatments are prolonged over time. Late initiation was accompanied by difficulties in school, periods of uncertainty, distress and/or family conflicts due to the complexities of parenting. CONCLUSIONS: Therapeutic itineraries started early in some cases and at a later stage in others. The initiation of treatments made it possible to use tools to bridge the gap of discrepancies between the biological and cultural lines of development.

Introducción. Los trastornos en el neurodesarrollo infantil constituyen un 10 % de las causas de discapacidad en la niñez. La búsqueda de atención médica configura itinerarios terapéuticos, entendidos como los procesos de búsqueda y atención para el cuidado de la salud, donde surgen oportunidades de diagnóstico y tratamiento. El objetivo fue explorar dichos itinerarios para comprender las oportunidades y barreras que se presentan para instaurar terapias y pautas de crianza que promuevan el neurodesarrollo. Población y métodos. Estudio cualitativo mediante entrevistas en profundidad a madres y padres de niños (de junio de 2018 a noviembre de 2019). El análisis se realizó sobre la base del modelo social de la discapacidad y del de desarrollo infantil propuesto por Vygotsky. Resultados. Se realizaron 16 entrevistas. Considerando la edad de inicio de los itinerarios terapéuticos y el diagnóstico, se identificaron dos grupos: aquellos que los comenzaron desde el nacimiento hasta los 2 años (inicio precoz) y quienes lo hicieron a partir de los 3 años (inicio en la primera infancia e infancia tardía). En el primero se habilita tempranamente la búsqueda de tratamiento, mientras que en el segundo se prolongaron en el tiempo las decisiones sobre el inicio y/o el tipo de terapias. El inicio tardío se acompañó de dificultades en la escuela, períodos de incertidumbre, angustia y/o conflictos familiares por las complejidades de la crianza. Conclusiones. Los itinerarios terapéuticos se iniciaron en forma precoz en algunos casos y tardía en otros. El inicio de tratamientos permitió incorporar herramientas para acortar la brecha de incongruencia entre las líneas biológica y cultural de desarrollo.

The Relation Between Protein Adsorption and Hemocompatibility of Antifouling Polymer Brushes.

Whenever an artificial surface comes into contact with blood, proteins are rapidly adsorbed onto its surface. This phenomenon, termed fouling, is then followed by a series of undesired reactions involving activation of complement or the coagulation cascade and adhesion of leukocytes and platelets leading to thrombus formation. Thus, considerable efforts are directed towards the preparation of fouling-resistant surfaces with the best possible hemocompatibility. Herein, a comprehensive hemocompatibility study after heparinized blood contact with seven polymer brushes prepared by surface-initiated atom transfer radical polymerization is reported. The resistance to fouling is quantified and thrombus formation and deposition of blood cellular components on the coatings are analyzed. Moreover, identification of the remaining adsorbed proteins is performed via mass spectroscopy to elucidate their influence on the surface hemocompatibility. Compared with an unmodified glass surface, the grafting of polymer brushes minimizes the adhesion of platelets and leukocytes and prevents the thrombus formation. The fouling from undiluted blood plasma is reduced by up to 99%. Most of the identified proteins are connected with the initial events of foreign body reaction towards biomaterial (coagulation cascade proteins, complement component, and inflammatory proteins). In addition, several proteins that are not previously linked with blood-biomaterial interaction are presented and discussed.

Aerobiological modelling II: A review of long-range transport models.

The long-range atmospheric transport models of pollen and fungal spores require four modules for their development: (i) Meteorological module: which contain the meteorological model, and it can be coupled to transport model with the same output configuration (spatio-temporal resolution), or uncoupled does not necessarily have the same output parameters. (ii) Emission module: settles the mass fluxes of bioaerosol, it can be done with a complex parameterization integrating phenological models and meteorological factors or by a simple emission factor. (iii) Sources of emission module, specifically refers to forestry/agronomy maps or, in the case of herbs and fungi, to potential geographical areas of emission. Obtaining the highest possible resolution in these maps allows establishing greater reliability in the modelling. (iv) Atmospheric transport module, with its respective established output parameters. The review and subsequent analysis presented in this article, were performed on published electronic scientific articles from 1998 to 2016. Of a total of 101 models applied found in 64 articles, 33 % performed forward modelling (using 15 different models) and 67 % made backward modelling (with three different models). The 88 % of the cases were applied to pollen (13 taxa) and 12 % to fungal spores (3 taxa). Regarding the emission module, 22 % used parametrization (four different parameters) and 10 % emission factors. The most used transport model was HYSPLIT (59 %: 56 % backward and 3 % forward) following by SILAM 10 % (all forward). Main conclusions were that the models of long-range transport of pollen and fungal spores had high technical-scientific requirements to development and that the major limitations were the establishment of the flow and the source of the emission.

Noise Levels and Sleep in a Surgical ICU.

Sleep is disturbed in critically ill patients and is a frequently overlooked complication. The aim of our study is to evaluate the impact of sound levels in our surgical ICU on our patients' sleep on the first night of admission. The study was performed in a tertiary care university hospital, in a 12-bed surgical ICU. Over a 6-week period, a total of 148 adult, non-intubated and non-sedated patients completed the study. During this six-week period, sound levels were continuously measured using a type II sound level meter. Sleep quality was evaluated using the Richards-Campbell Sleep Questionnaire (RCSQ), which was completed both by patients and nurses on the first morning after admission. A non-significant correlation was found between night sound levels and sleep quality in the overall sample (r = -1.83, 95% CI; -4.54 to 0.88, p = 0.19). After multivariable analysis, a correlation was found between higher sound levels at night and lower RCSQ evaluations (r = -3.92, 95% CI; -7.57 to -0.27, p = 0.04). We found a significant correlation between lower sound levels at night and a better quality of sleep in our patients; for each 1 dBA increase in LAFeq sound levels at night, patients scored 3.92 points lower on the sleep questionnaire.

In situ generation of a Zwitterionic fluorescent probe for detection of human serum albumin protein.

In this article, a new approach for human serum albumin selective fluorophore design has been reported. The fluorophore reported here comprises a substituted phenol donor and a cationic benzo[e]indolium acceptor connected with a π bond. Originally, the cationic fluorophore did not bind with human serum albumin. Upon deprotonation of the phenolic-OH by a water molecule the cationic form was transformed into an active zwitterionic form. Spectroscopic studies and theoretical calculations revealed that the new active form remained in a zwitterionic state in neutral aqueous solution, and it formed a strong supramolecular complex with human serum albumin. The spontaneous complexation resulted multi-fold increase of fluorescence intensity which increased linearly with the concentrations of the protein, thus giving an analytical tool to monitor human serum albumin in aqueous samples. We believe, this simple strategy applied on appropriate fluorogenic scaffolds would prove useful to develop new and improved turn-on fluorescent probes for pH regulated biological applications.