Successful treatment of severe recalcitrant vernal keratoconjunctivitis and atopic dermatitis associated with elevated IgE levels with omalizumab.

We report the clinical case of an atopic patient with important manifestations impacting the quality of life at the cutaneous and ocular site. The condition resisted conventional treatments, and omalizumab had to be used to treat the disease successfully.

[Evaluation of the experience of children and parents in a Pediatric service]. / Evaluación de la experiencia de niños y padres en un servicio de Pediatría.

BACKGROUND AND OBJECTIVE: Pediatric patient care implies a duplication of user, the children who receive assistance and their parents. OBJECTIVE: to evaluate the perception and compared experience between children seen in pediatric observation and their parents. PATIENTS AND METHODS: Cross-sectional study using a survey prior to discharge, to children aged 4-13 years admitted between April 2017 and November 2018 and their parents. A random sample of 125 child-parent pairs was taken. Both groups were compared with the Chi-square test and the child-father agreement with the Kappa index (KI), using SPSS v.25. RESULTS: Overall satisfaction was 99.2% in children and 100% in adults, with no significant differences between the two (p=0.314). There were also no significant differences between children and parents in the best valued aspects: staff interest (100% and 100%; p=not calculable); treatment of staff (100% and 99.2%; p=0.318); space (99.2% and 99.2%; p=1); information (98.4% and 100%; p=0.993); time with relatives (98.4% and 98.4%; p=0.993); cleaning (98.4% and 97.6%; p=0.651). The worst valued aspects in children: food (83.2% and 93.2%; p=0.016) and entertainment (89.5% and 94.2%; p=0.179); in adults: comfort (96.8% and 90.2%; p=0.036). There was moderate child-parent concordance in speed of attention (IK 0.561; p<0.001), time with relatives (0.492; p<0.001) and entertainment (0.489; p<0.001). In four questions, the IK could not be calculated because there were no dissatisfied adults and / or children. CONCLUSIONS: The global satisfaction of children and adults was high and consistent in most items. Parent surveys reflect the views of children.

Benzyloxycarbonyl-proline-prolinal (ZPP): Dual complementary roles for neutrophil inhibition.

Neutrophil influx and activation contributes to organ damage in several major lung diseases. This inflammatory influx is initiated and propagated by both classical chemokines such as interleukin-8 and by downstream mediators such as the collagen fragment cum neutrophil chemokine Pro-Gly-Pro (PGP), which share use of the ELR + CXC receptor family. Benzyloxycarbonyl-proline-prolinal (ZPP) is known to suppress the PGP pathway via inhibition of prolyl endopeptidase (PE), the terminal enzyme in the generation of PGP from collagen. However, the structural homology of ZPP and PGP suggests that ZPP might also directly affect classical glutamate-leucine-arginine positive (ELR+) CXC chemokine signaling. In this investigation, we confirm that ZPP inhibits PE in vitro, demonstrate that ZPP inhibits both ELR + CXC and PGP-mediated chemotaxis in human and murine neutrophils, abrogates neutrophil influx induced by murine intratracheal challenge with LPS, and attenuates human neutrophil chemotaxis to sputum samples of human subjects with cystic fibrosis. Cumulatively, these data demonstrate that ZPP has dual, complementary inhibitory effects upon neutrophil chemokine/matrikine signaling which make it an attractive compound for clinical study of neutrophil inhibition in conditions (such as cystic fibrosis and chronic obstructive pulmonary disease) which evidence concurrent harmful increases of both chemokine and matrikine signaling.

Terebratulide brachiopod shell biomineralization by mantle epithelial cells.

To understand mineral transport pathways for shell secretion and to assess differences in cellular activity during mineralization, we imaged with TEM and FE-SEM ultrastructural characteristics of outer mantle epithelium (OME) cells. Imaging was carried out on Magellania venosa shells embedded/etched, chemically fixed/decalcified and high-pressure frozen/freeze-substituted samples from the commissure, central shell portions and from puncta. Imaging results are complemented with morphometric evaluations of volume fractions of membrane-bound organelles. At the commissure the OME consists of several layers of cells. These cells form oblique extensions that, in cross-section, are round below the primary layer and flat underneath fibres. At the commissure the OME is multi-cell layered, in central shell regions it is single-cell layered. When actively secreting shell carbonate extrapallial space is lacking, because OME cells are in direct contact with the calcite of the forming fibres. Upon termination of secretion, OME cells attach via apical hemidesmosomes to extracellular matrix membranes that line the proximal surface of fibres. At the commissure volume fractions for vesicles, mitochondria and lysosomes are higher relative to single-cell layered regions, whereas for endoplasmic-reticulum and Golgi apparatus there is no difference. FE-SEM, TEM imaging reveals the lack of extrapallial space between OME cells and developing fibres. In addition, there is no indication for an amorphous precursor within fibres when these are in active secretion mode. Accordingly, our results do not support transport of minerals by vesicles from cells to sites of mineralization, rather by transfer of carbonate ions via transport mechanisms associated with OME cell membranes.

[Personal self-regulation and perceived maladjusted school behaviors]. / Autorregulación personal y percepción de los comportamientos escolares desadaptativos.

The purpose of this study is to confirm the extent to which subjects' ability to self-regulate, during mid-adolescence, influences their perception of maladjustment problems. The sample comprised 888 adolescents between 12 and 17 years of age. The study followed an inferential methodology, using two instruments, a Spanish version of the Personal Self-regulation Questionnaire (2003, 2007) and the Cuestionario de Problemas de Desadaptación Escolar [Questionnaire for the Assessment of School Maladjustment Problems] (2007) to measure the variables of interest. Results from the inferential analyses (ANOVAS) suggest that the degree of personal self-regulation is interdependent with respect to perceived maladjustment and relational problems at school. Results and implications for future research are discussed.

Autorregulación personal y percepción de los comportamientos escolares desadaptativos / Personal self-regulation and perceived maladjusted school behaviors

Este estudio tiene como objetivo comprobar en qué grado la capacidad de autorregulación, en la adolescencia media, incide en su percepción de los problemas de desadaptación escolar. La muestra está constituida por 888 adolescentes de 12 a 17 años de edad. El estudio emplea una metodología inferencial, utilizando dos instrumentos, una versión castellana del Cuestionario de Autorregulación Personal (2003, 2007) y el Cuestionario de Problemas de Convivencia Escolar (2007) para medir las variables objeto de estudio. Los resultados de los análisis inferenciales (ANOVAS) sugieren que el grado de autorregulación personal es interdependiente respecto a la percepción de los problemas de desadaptación y convivencia en los centros escolares. Se discuten los resultados e implicaciones para futuras investigaciones (AU)

The purpose of this study is to confirm the extent to which subjects’ ability to self-regulate, during mid-adolescence, influences their perception of maladjustment problems. The sample comprised 888 adolescents between 12 and 17 years of age. The study followed an inferential methodology, using two instruments, a Spanish version of the Personal Self-regulation Questionnaire (2003, 2007) and the Cuestionario de Problemas de Desadaptación Escolar [Questionnaire for the Assessment of School Maladjustment Problems] (2007) to measure the variables of interest. Results from the inferential analyses (ANOVAS) suggest that the degree of personal self-regulation is interdependent with respect to perceived maladjustment and relational problems at school. Results and implications for future research are discussed (AU)

Síndrome de Munchausen por poderes / Munchausen syndrome by proxy

El síndrome de Munchausen por poderes (SMP) constituye una patología de difícil diagnóstico, causante de gran morbimortalidad. El conocimiento de las características generales tanto de la víctima como del perpetrador del mismo puede ser de gran ayuda para el reconocimiento precoz de este cuadro. Recientemente, la American Professional Society on the Abuse of Children ha desarrollado una actualización terminológica del síndrome. Abordamos dicha actualización y presentamos seis casos diagnosticados en nuestro hospital analizando las características generales de la víctima y del perpetrador y las comparamos con las de la literatura médica (AU)

Munchausen syndrome by proxy is an illness which is very difficult to diagnose. It has a high morbidity and mortality rate. The knowledge of the characteristics of the victim and the perpetrator can be quite useful for its early recognition. The American Professional Society on the Abuse of Children, has recently brought the terms for the syndrome up to date. We look at this updating and present six cases diagnosed in our hospital, analysing their main features and comparing them with the medical literatura (AU)

Endoprosthetic replacement for malignant bone tumours of the proximal femur.

Limb salvage procedures are considered the gold standard in the treatment of bone tumours. The use of modular prostheses is one of the options for reconstruction after bone resection in primary tumours and in very restricted cases also in bone metastases. The authors report the results of 27 consecutive cases of proximal femur bone resections and reconstructions with modular prostheses, using the Mutars system. Soft tissue reconstruction and anchorage to the implant was performed using the Trevira tube. The system stem used showed good mechanical resistance, and implant removal was required for infection in only two cases. Functional results were related to the degree of bone resection and muscular sacrifice. (Hip International 2005; 15: 218-22).

Triglyceride-rich lipoprotein abnormalities in CAPD-treated patients.

In the present study intermediate-density lipoproteins (IDL) and very-low-density lipoproteins (VLDL) composition, structure, and mass were analysed in fasting uraemic patients on continuous ambulatory peritoneal dialysis (CAPD) (n = 12) and on haemodialysis (HD) (n = 15), and in 15 healthy volunteers. All the groups were matched for sex, age, and time on dialysis. Both groups of patients had elevated very-low-density lipoprotein levels, CAPD patients four and HD group three times that of control. We found a fourfold and a twofold increase in the concentration of IDL cholesterol in the CAPD and HD group respectively when they were compared with the control group. Both groups of patients present an increased VLDL mass. The CAPD group showed a four-fold increase in IDL mass compared with the control group, which indicated a preponderance of large size and suggested that defective IDL clearance was involved. The IDL composition of the CAPD patients was significantly different from that of the HD patients: a twofold increase in IDL mass was observed in the CAPD patients if compared with HD patients. We report new data concerning the metabolism of triglyceride-rich lipoproteins in CAPD treated patients, which confirm the adverse effect of CAPD on serum lipids.

Atrial natriuretic factor in patients on continuous ambulatory peritoneal dialysis.

The aim of this study was to compare the levels of the atrial natriuretic factor (ANF) and the renin system in patients on continuous ambulatory peritoneal dialysis (CAPD) with patients on chronic hemodialysis (HD). We studied three groups. The CAPD group comprised 10 patients (25-66 years); the HD group: 10 patients (35-69 years), before (pre-HD) and after (post-HD) a HD session. The control group comprised 10 subjects with normal renal function (29-65 years), matched for age, height, weight, and diastolic pressure with the CAPD group. Blood pressure (BP) and blood samples for plasma renin activity (PRA), plasma aldosterone (PA), and ANF were taken. The BP and levels of ANF, PRA and PA were: in the control group, 121 +/- 15/75 +/- 4 mmHg, 7.3 +/- 5.6 pmol/L, 1.1 +/- 0.8 ng/mL/hour, 0.4 +/- 0.3 nmol/L. In the CAPD group, 132 +/- 26/76 +/- 12 mmHg (NS), 8.3 +/- 3.5 pmol/L (NS), 5.6 +/- 4.4 ng/mL/hour (p < 0.001), 4.9 +/- 4.0 nmol/L (p < 0.001). In the pre-HD, 159 +/- 25/95 +/- 12 mmHg (p < 0.001), 16.0 +/- 8.5 pmol/L (p < 0.005), 11.99 +/- 9.0 ng/mL/hour (p < 0.001), 2.6 +/- 2.3 nmol/L (p < 0.001). In the post-HD, 145 +/- 29/84 +/- 15 mmHg (p < 0.05 vs CG), 13.4 +/- 6.9 pmol/L (p < 0.05 vs control), 14.9 +/- 10.3 ng/mL/hour (p < 0.001 vs control), 3.8 +/- 2.9 nmol/L (p < 0.001 vs control).(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacokinetics of fosfomycin during hemodialysis.

A study was made of the elimination of fosfomycin by the membrane of the artificial kidney in 10 patients with hemodialysis and a creatinine clearance of less than 5 ml/min. To do so we determined the half-life, the dialysance, the percentage of total loss and the percentage of loss by the artificial kidney. We reached the conclusion that fosfomycin is heavily dialyzed (D = 64 ml/min), it is entirely eliminated by the kidneys and its half-life is therefore affected very little (an increase of only about 30 min is produced). All of this leads to a practical schema by which the entire initial dose should be replenished at the end of each dialysis.