Acousto-holographic optical tweezers.

Acousto-optic deflectors (AODs) allow the creation of multiple optical traps by time-sharing, that is, by rapidly cycling the laser focus between designated spatial locations. The traps thus formed are not permanent. In this Letter, we successfully demonstrate the creation of multiple and permanent traps by means of AODs driven by specially encoded radio frequency signals. The generation of complex acoustic signals allows us to treat such devices as super-fast spatial light modulators. Using this technique, it is possible to generate several static optical trap arrays and switch them at kilohertz (kHz) rates, allowing independent control of each trap group. Additionally, we discuss the compatibility of this method with precise force and position measurements, and the improvement in their frequency bandwidth compared to time-sharing optical tweezers, especially when many objects are trapped.

Optimized meropenem dosage regimens using a pharmacokinetic/pharmacodynamic population approach in patients undergoing continuous venovenous haemodiafiltration with high-adsorbent membrane.

BACKGROUND: The pharmacokinetics (PK) of antibiotics change during sepsis and continuous renal replacement therapies in critically ill patients. Limited evidence exists on the use of the oXiris® high-adsorbent membrane. OBJECTIVES: To develop a PK/pharmacodynamic (PD) model for meropenem in critically ill sepsis patients undergoing continuous venovenous haemodiafiltration (CVVHDF) with the oXiris® membrane, and to design an optimal dosing regimen assessed according to the PTA. METHODS: A prospective, open-label, observational PK trial was performed (EUDRACT 2011-005902-30). We conducted PK studies (plasma and ultrafiltrate) for at least 24 h after concomitant administration of CVVHDF and meropenem 1 g q8h. We constructed a PK model using the non-linear mixed-effects approach (NONMEM 7.3). We evaluated the suitability of different dosage regimens using Monte Carlo simulations and calculated the PTA as the percentage of subjects achieving a given percentage of time above the MIC (fT>MIC). RESULTS: The PK of meropenem was best captured by a two-open-compartment model with zero-order input kinetics and first-order elimination. Extracorporeal CL was 7.78 L/h [relative standard error (RSE) 16.45 L/h] and central compartment V (Vc) was 24.9 L (RSE 13.73 L). Simulations showed that, for susceptible Pseudomonas aeruginosa isolates (EUCAST MIC ≤2 mg/L) and attainment of 100%fT>MIC, 500 mg q8h given as extended (EI) or continuous infusion (CI) would be sufficient. For a target of 100%fT>4×MIC, CI of 3000 mg q24h or 2000 mg q8h administered as EI or CI would be required. CONCLUSIONS: We have constructed a PK model of meropenem in sepsis patients undergoing CVVHDF using the oXiris® membrane. This tool will support physicians when calculating the optimal initial dose.

An inflammation-based prognostic score, the C-reactive protein/albumin ratio predicts the morbidity and mortality of patients on parenteral nutrition.

BACKGROUND: There is no "gold standard" score for predicting poor-nutrition-related outcomes. The objective of this study was to identify the optimal predictive score, based on inflammatory parameters, for the clinical outcomes of parenteral nutrition (PN). MATERIAL AND METHODS: This was a 4-year retrospective observational study of 460 patients treated with PN. C-reactive protein (CRP), prealbumin, albumin, CRP/prealbumin and CRP/albumin were studied as potential prognostic scores at the beginning of PN for clinical outcomes during PN. Three different statistical approaches were developed: 1) A univariate analysis of each of the 5 prognostic scores and 5 multivariate models for CRP/albumin and CRP/prealbumin to study their association with exitus, infection, sepsis, liver failure, renal impairment, cancer, intensive care unit stay, mechanical ventilation; 2) Univariate and multivariate survival analysis of PN length, intensive care unit (ICU) length of saty and days of mechanical ventilation vs CRP/albumin and CRP/prealbumin; 3) A ROC analysis of the prognostic accuracy of CRP/albumin and CRP/prealbumin over morbidity/mortality. RESULTS: 1) CRP, albumin and CRP/albumin gave more information about morbidity/mortality than prealbumin and CRP/prealbumin. CRP/albumin was statistically significant for exitus (OR 1.85; CI 95%: 1.00-3.45), infection (OR 2.15; CI 95%: 1.22-3.80), sepsis (OR 2.82; CI 95%: 1.69-4.70) and liver failure (OR 2.66; CI 95%: 1.55-4.58). CRP/prealbumin for sepsis was (OR 2.21; CI 95%: 1.34-3.64) and for liver failure (OR 2.04; CI 95%: 1.17-3.53); 2) CRP/albumin and CRP/prealbumin significantly predict PN duration, days in ICU and days on mechanical ventilation; 3) and are related to exitus, infection, sepsis and liver failure. CONCLUSION: The CRP/albumin score at the beginning of PN treatment has more prognostic capability than CRP/prealbumin, albumin or prealbumin. The systematic use of this score could help to identify those patients with higher risk.

Parenteral fish oil and liver function tests in hospitalized adult patients receiving parenteral nutrition: A propensity score-matched analysis.

BACKGROUND & AIMS: Intravenous fat emulsions are associated with liver disease and there is some evidence that the administration of intravenous fish oil (FO) may be useful in reversing it. The aim of our study was to assess whether there are differences in the changes of liver function tests (LFTs) in hospitalized adult patients with parenteral nutrition (PN) with FO and vegetal lipids vs patients without FO. The secondary aim was to study the relationship between impaired LFT and FO. METHODS: This was a 4-year, propensity score-matched analysis including patients aged ≥18 years treated with PN for ≥10 days. The exclusion criteria were previous liver disease, biliary disorders or pancreatic cancer, and altered initial LFT values. Patients were classified into 2 groups: FO cohort (patients who received FO - in addition to vegetal oil - after the first week of PN) and the vegetal oil cohort (patients who received only vegetal oil). A propensity score matched cohort design was developed. Univariate analyses were used to study the changes in LFTs. To evaluate whether LFT alterations vary with FO administration, four stepwise multiple linear regression models were conducted. RESULTS: 52 patients were included, 52% men, median 66 (55-75) years and 69 kg (61.7-78.8), with 18.5 (14-31.8) days of PN treatment. Maximum FO supplementation was 23%. During the first week with PN (none of the groups receiving FO), gammaglutamyl transferase (GGT), alkaline phosphatase (AP) and total bilirubin (BIL) increased significantly. Comparing LFT values at seven days of PN with at the end of PN treatment, the univariate analysis showed a better response for the FO group. The group without FO showed a significant increase for GGT and AP. In multivariate models, the percentage of FO administered was associated with a decrease in GGT, B = -0.33 [CI 95% = -0.54/-0.12], in AP, B = -0.12 [CI 95% = -0.20/-0.03] and ALT, B = -0.12 [CI 95% = -0.21/-0.024]. CONCLUSIONS: Lipid composition plays a significant role in LFT alteration associated with PN, and FO intravenous lipid emulsions (ILEs) minimize disturbance of LFTs in hospitalized adult patients.

Artificially-induced organelles are optimal targets for optical trapping experiments in living cells.

Optical trapping supplies information on the structural, kinetic or rheological properties of inner constituents of the cell. However, the application of significant forces to intracellular objects is notoriously difficult due to a combination of factors, such as the small difference between the refractive indices of the target structures and the cytoplasm. Here we discuss the possibility of artificially inducing the formation of spherical organelles in the endoplasmic reticulum, which would contain densely packed engineered proteins, to be used as optimized targets for optical trapping experiments. The high index of refraction and large size of our organelles provide a firm grip for optical trapping and thereby allow us to exert large forces easily within safe irradiation limits. This has clear advantages over alternative probes, such as subcellular organelles or internalized synthetic beads.

Use of Subjective Global Assessment, Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 to evaluate the nutritional status of non-critically ill patients on parenteral nutrition.

OBJECTIVE: To evaluate the nutritional status of non-critically ill digestive surgery patients at the moment of parenteral nutrition initiation using three different nutritional test tools and to study their correlation. To study the association between the tests and the clinical and laboratory parameters used in the follow-up of PN treatment. METHODS: Prospective study over 4 months. Anthropometric and clinical variables were recorded. Results of Subjective Global Assessment; Patient-Generated Subjective Global Assessment; and Nutritional Risk Screening 2002 were compared applying kappa test. Relationship between the clinical and laboratory parameters with Subjective Global Assessment was studied by multinominal regression and with the other two tests by multiple linear regression models. Age and sex were included as adjustment variables. RESULTS: Malnutrition in 45 studied patients varied from 51% to 57%. Subjective Global Assessment correlated well with Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 (κ = 0531 p = 0.000). The test with the greatest correlation with the clinical and analytical variables was the Nutritional Risk Screening 2002. Worse nutritional state in this test was associated with worse results in albumin (B = -0.087; CI = -0.169/-0.005], prealbumin (B = -0.005; CI = [-0.011/-0.001]), C-reactive protein (B = 0.006;CI = [0.001/ 0.011]) and leukocytes (B = 0.134; CI = [0.031/0.237]) at the en of parenteral nutrition treatment. CONCLUSIONS: Half of the digestive surgery patients were at malnutritional risk at the moment of initiating parenteral nutrition. Nutritional Risk Screening 2002 was the test with best association with the parameters used in the clinical follow-up of parenteral nutrition treated patients.

Objetivo: Evaluar el estado nutricional de pacientes no críticos de cirugía digestiva, en el momento de iniciar la nutrición parenteral, utilizando tres tests de evaluación nutricional. Estudiar la correlación entre los tests y su asociación con los parámetros clínicos y de laboratorio utilizados para el seguimiento de estos pacientes. Métodos: Estudio prospectivo de 4 meses. Se recogen variables antropométricas y clínicas. Los resultados de Subjective Global Assessment, Patient-Generated Subjective Global Assessment y Nutritional Risk Screening 2002 se comparan mediante test kappa. La relación entre las variables clínicas y de laboratorio con Subjective Global Assessment se estudian con regresión multinominal; y con Patient-Generated Subjective Global Assessment y Nutritional Risk Screening mediante regresión lineal múltiple. Edad y sexo se introdujeron como variables de ajuste. Resultados: La desnutrición en 45 pacientes estudiados variaba entre el 51% y el 57%. Subjective Global Assessment correlacionaba bien con Patient-Generated Subjective Global Assessment y el Nutritional Risk Screening (= 0,531 p = 0,000). Nutritional Risk Screening 2002 mostró mejor asociación con variables clínicas y analíticas: peor estado nutricional en este test se asoció con peor comportamiento de albúmina (B = -0,087; CI = -0,169/-0,005]); prealbumina (B = -0,005; CI = [-0,011/ 0,001]), proteína C reactiva (B = 0,006;CI = [0,001/0,011]) y leucocitos (B = 0,134; CI = [0,031/0,237]) al final de la nutrición parenteral. Discusión: La mitad de los pacientes de cirugía digestiva presentan algún grado de desnutrición en el momento de iniciar la nutrición parenteral. El Nutritional Risk Screening 2002 se mostró como el test con mayor relación con las variables utilizadas en el seguimiento clínico de los pacientes con nutrición parenteral.

Use of Subjective Global Assessment, Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 to evaluate the nutritional status of non-critically ill patients on parenteral nutrition / Utilización de Subjective Global Assessment, patient-generated subjective global assessment y nutritional risk screening 2002 para evaluar el estado nutricional de pacientes no críticos con nutrición parenteral

Objective: To evaluate the nutritional status of non-critically ill digestive surgery patients at the moment of parenteral nutrition initiation using three different nutritional test tools and to study their correlation. To study the association between the tests and the clinical and laboratory parameters used in the follow-up of PN treatment. Methods: Prospective study over 4 months. Anthropometric and clinical variables were recorded. Results of Subjective Global Assessment; Patient-Generated Subjective Global Assessment; and Nutritional Risk Screening 2002 were compared applying kappa test. Relationship between the clinical and laboratory parameters with Subjective Global Assessment was studied by multinominal regression and with the other two tests by multiple linear regression models. Age and sex were included as adjustment variables. Results: Malnutrition in 45 studied patients varied from 51% to 57%. Subjective Global Assessment correlated well with Patient-Generated Subjective Global Assessment and Nutritional Risk Screening 2002 (κ = 0531 p = 0.000). The test with the greatest correlation with the clinical and analytical variables was the Nutritional Risk Screening 2002. Worse nutritional state in this test was associated with worse results in albumin (B = -0.087; CI = -0.169/-0.005], prealbumin (B = -0.005; CI = [-0.011/-0.001]), C-reactive protein (B = 0.006;CI = [0.001/ 0.011]) and leukocytes (B = 0.134; CI = [0.031/0.237]) at the en of parenteral nutrition treatment. Conclusions: Half of the digestive surgery patients were at malnutritional risk at the moment of initiating parenteral nutrition. Nutritional Risk Screening 2002 was the test with best association with the parameters used in the clinical follow-up of parenteral nutrition treated patients (AU)

Objetivo: Evaluar el estado nutricional de pacientes no críticos de cirugía digestiva, en el momento de iniciar la nutrición parenteral, utilizando tres tests de evaluación nutricional. Estudiar la correlación entre los tests y su asociación con los parámetros clínicos y de laboratorio utilizados para el seguimiento de estos pacientes. Métodos: Estudio prospectivo de 4 meses. Se recogen variables antropométricas y clínicas. Los resultados de Subjective Global Assessment, Patient-Generated Subjective Global Assessment y Nutritional Risk Screening 2002 se comparan mediante test kappa. La relación entre las variables clínicas y de laboratorio con Subjective Global Assessment se estudian con regresión multinominal; y con Patient-Generated Subjective Global Assessment y Nutritional Risk Screening mediante regresión lineal múltiple. Edad y sexo se introdujeron como variables de ajuste. Resultados: La desnutrición en 45 pacientes estudiados variaba entre el 51% y el 57%. Subjective Global Assessment correlacionaba bien con Patient-Generated Subjective Global Assessment y el Nutritional Risk Screening (κ = 0,531 p = 0,000). Nutritional Risk Screening 2002 mostró mejor asociación con variables clínicas y analíticas: peor estado nutricional en este test se asoció con peor comportamiento de albúmina (B = -0,087; CI = -0,169/-0,005]); prealbumina (B = -0,005; CI = [-0,011/ 0,001]), proteína C reactiva (B = 0,006;CI = [0,001/0,011]) y leucocitos (B = 0,134; CI = [0,031/0,237]) al final de la nutrición parenteral. Discusión: La mitad de los pacientes de cirugía digestiva presentan algún grado de desnutrición en el momento de iniciar la nutrición parenteral. El Nutritional Risk Screening 2002 se mostró como el test con mayor relación con las variables utilizadas en el seguimiento clínico de los pacientes con nutrición parenteral (AU)

Liver function test alterations associated with parenteral nutrition in hospitalized adult patients: incidence and risk factors.

BACKGROUND: Parenteral nutrition-associated liver dysfunction can be progressive and irreversible, particularly in children and patients with long-term treatment. This study has assessed the incidence of abnormal liver function tests in hospitalized adults during short term parenteral nutrition (PN) and has investigated risk factors for developing alterations of each parameter. METHODS: A prospective cohort study of parenteral nutrition treated patients with preserved liver function at baseline. Variables examined included nutritional and clinical data and laboratory parameters. Determinations were performed before starting PN and weekly until liver function test alteration was observed. Risk factors were investigated by four stepwise forward logistical regressions. RESULTS: Eighty patients were included, 57.5% had liver function test alterations. PN mean duration was 15.9 (8-54) days. Mean days with PN and additional enteral/ oral nutrition were 1.5 (0-20). The following associations were found: gamma-glutamyl-transferase increased with soybean lipid intake and absolute diet; alkaline phosphatase increased with septic shock; alanine transaminase increased with septic shock, hyperglycemia and elevated creatinine; total bilirubin increased with septic shock, absolute diet, low prealbumin and glucose, and high creatinine. CONCLUSIONS: The incidence of altered liver function tests is high in adult hospitalized patients treated with short-term PN. However, the effect of nutritional factors in this alteration is low. Oral/enteral nutrition and reduction of soybean lipid supply can reduce increases in some liver function tests such as gamma-glutamyl-transferase and total bilirubin. The high association between all liver function tests and clinical systemic-hypermetabolic variables suggest the importance of specific nutritional strategies for this condition.

Liver function test alterations associated with parenteral nutrition in hospitalized adult patients; incidence and risk factors / Alteraciones de los parámetros hepáticos asociados con la administración de nutrición parenteral en pacientes adultos hospitalizados; incidencia y factores de riesgo

Background: Parenteral nutrition-associated liver dysfunction can be progressive and irreversible, particularly in children and patients with long-term treatment. This study has assessed the incidence of abnormal liver function tests in hospitalized adults during short term parenteral nutrition (PN) and has investigated risk factors for developing alterations of each parameter. Methods: A prospective cohort study of parenteral nutrition treated patients with preserved liver function at baseline. Variables examined included nutritional and clinical data and laboratory parameters. Determinations were performed before starting PN and weekly until liver function test alteration was observed. Risk factors were investigated by four stepwise forward logistical regressions. Results: Eighty patients were included, 57.5% had liver function test alterations. PN mean duration was 15.9 (8-54) days. Mean days with PN and additional enteral/ oral nutrition were 1.5 (0-20). The following associations were found: gamma-glutamyl-transferase increased with soybean lipid intake and absolute diet; alkaline phosphatase increased with septic shock; alanine transaminase increased with septic shock, hyperglycemia and elevated creatinine; total bilirubin increased with septic shock, absolute diet, low prealbumin and glucose, and high creatinine. Conclusions: The incidence of altered liver function tests is high in adult hospitalized patients treated with short-term PN. However, the effect of nutritional factors in this alteration is low. Oral/enteral nutrition and reduction of soybean lipid supply can reduce increases in some liver function tests such as gamma-glutamyl-transferase and total bilirubin. The high association between all liver function tests and clinical systemic-hypermetabolic variables suggest the importance of specific nutritional strategies for this condition (AU)

Introducción: La alteración hepática asociada a la nutrición parenteral (NP) puede ser progresiva e irreversible particularmente en niños y en tratamientos de larga duración. El objetivo de este estudio es establecer la incidencia de las alteraciones de los parámetros hepáticos en pacientes adultos hospitalizados en tratamiento con NP y estudiar los factores de riesgo asociados al desarrollo de las alteraciones de cada uno de los parámetros hepáticos. Métodos: Estudio prospectivo de cohortes de los pacientes tratados con NP con función hepática normal al inicio del tratamiento. Se estudiaron parámetros clínicos, nutricionales y analíticos. Las determinaciones se hicieron antes de iniciar la nutrición y semanalmente hasta que se detectó la alteración de algún parámetro hepático. Los factores de riesgo asociados a la alteración hepática se estudiaron con 4 regresiones logísticas. Resultados: Se incluyeron 80 pacientes y 57,5% mostraron alteraciones hepáticas. La media de duración de la NP fue 15,9 días (8-54) y la media de días con nutrición enteral u oral concomitantes fue de 1,5 (0-20). Se encontraron las siguientes asociaciones: la gamma-glutamil-transferasa aumentaba con la cantidad de lípidos de soja administrados y los días en dieta absoluta; la fosfatasa alcalina con el shock séptico, la alanina-aminotransferasa con el shock séptico, la hiperglucemia y los valores elevados de creatinina; la bilirrubina total con el shock séptico, la dieta absoluta, valores bajos de prealbúmina y glucosa; y valores altos de creatinina. Conclusiones: La incidencia de alteraciones de los parámetros hepáticos es elevada en pacientes adultos hospitalizados tratados con NP, aunque el efecto de los factores nutricionales en esta alteración es bajo. La nutrición oral/enteral y la reducción de los lípidos en forma de soja pueden reducir el aumento de algunos parámetros hepáticos como la gamma-glutamiltransferasa y la bilirrubina total. La gran asociación entre todos los parámetros hepáticos y las variables sistémicas indicadoras de hiper-metabolismo apuntan a la importancia de las estrategias nutricionales específicas en esta situación (AU)

Prospects and limitations of microbial pesticides for control of bacterial and fungal pomefruit tree diseases.

The tree constitutes an ecosystem in which microorganisms play an essential role in its functionality. Interactions that microorganisms establish with plants may be beneficial or detrimental and are of extreme importance in the exploitation of trees in agriculture as crop production systems. Fruit trees, especially pomefruit trees including apple, pear and several ornamentals are of great economic importance but its production is affected by several diseases. Fungal and bacterial fruit tree diseases are mainly controlled with chemical fungicides and bactericides, but health and environmental concerns about the use of chemical pesticides have result in strong regulatory actions and have stimulated the development of beneficial microorganisms as microbial pesticides. Up to now, several microorganisms have been registered in different countries and in the EU as biocontrol agents (BCA) covering mainly fire blight, soil-borne fungal diseases and postharvest fruit fungal rot. The key aspects in the success of this technology for disease control are related to biosafety and environmental impact of biocontrol agents, the traceability and fate in the environment and food chain, the improvement by physiological, genetic engineering or the use of mixtures or formulations as well as the industrial production and development of delivery systems for treatment application to trees.

Evaluation of ISO enrichment real-time PCR methods with internal amplification control for detection of Listeria monocytogenes and Salmonella enterica in fresh fruit and vegetables.

AIMS: To provide with a quick method for qualitative detection, in less than three days, of Salmonella enterica and Listeria monocytogenes in fresh fruit and vegetables. METHODS AND RESULTS: The method was based on coupling International Standard Organization (ISO) enrichment to a real-time PCR with internal amplification control (IAC), in a duplex format, without additional DNA purification. The performance was tested on different plant products. Both bacterial pathogens were consistently detected with a limit of detection (LOD) of 1 CFU in 25 g after enrichment, except for soybean sprouts. Levels of S. enterica, ranging from 1 to 10 CFU in 25 g after enrichment were detected with different enrichment broths. CONCLUSIONS: For both pathogens, the LOD was similar to that of the corresponding ISO method, while decreasing the analysis time and handling needs. SIGNIFICANCE AND IMPACT OF THE STUDY: The agreement between standard ISO and the enrichment real-time PCR(IAC)-based methods make the latter method as a promising alternative for quick and reliable detection of food-borne pathogens in fresh fruit and vegetables in routine laboratories.

[Intermediate syndrome after organophosphate poisoning despite continuous infusion of pralidoxime]. / Síndrome intermedio en el transcurso de una intoxicación por organofosforados a pesar de una infusión continua de pralidoxima.

Acute organophosphate poisoning leads to a cholinergic crisis secondary to an acetylcholine rise, developed by an acetylcholinesterase inhibition. In some cases, after the resolution of the initial cholinergic signs and symptoms, an intermediate syndrome occurs, characterized by a delayed development of proximal and diaphragmatic muscle paralysis. We describe a case of a 67-year-old man who developed an intermediate syndrome after oxydemeton-metryl ingestion in a suicide attempt, despite a continuous pralidoxime infusion. Several hypotheses have been developed to explain the aetiology of this intermediate syndrome (neuromuscular junction dysfunction, inadequate poisoning treatment, late beginning of the oxime administration, etc). Intermediate syndrome manifestation will depend on the organophosphate's organism persistence and its chemical structure, and also on the time elapsed between the poisoning and the antidote administration.

[Optimising the quality of the unit dose dispensing process through the implementation of the semi-automated Kardex system]. / Optimización de la calidad del proceso de dispensación de medicamentos en dosis unitaria mediante la implantación del sistema semiautomático Kardex.

OBJECTIVE: To evaluate the effect of the incorporation of the semi-automated Kardex medication storage and dispensing system on the quality of the filling process of medicine trolleys in unit doses. METHOD: The speed of filling medicine trolleys in unit doses using the Kardex system was analysed retrospectively (n = 33,946 dispensings) and compared with the manual filling system (n = 5,284 dispensings); different filling procedures were used and compared. For each filling system and procedure, we obtained information for the number of dispensings and the time spent carrying this out. The speed of the process was calculated as the number of dispensings per hour. In addition, the drugs contained in the Kardex system were checked and the correspondence between both the actual and the theoretical content was assessed. RESULTS: The speed of the trolley filling process, expressed as the number of dispensings per hour, increased from 394 with the manual system (filling trolleys individually, n = 5,284 dispensings) to 417, 540 and 592 with the Kardex system when trolleys were filled individually (n = 16,530 dispensings), or grouped in two (n = 10,369 dispensings) or in three (n = 7,047 dispensings) respectively, at the start of the filling process. The check of the contents in the Kardex system detected 36% of trays with differences in quantity, one tray with out of date medication and three trays which should in theory have been empty and contained medication. CONCLUSIONS: The Kardex system optimises the speed of trolley filling with regard to the manual system, provided that the trolleys are grouped at the time of starting the preparation. The check of the cabinet contents shows that possibilities of error exist, related to its handling, which can be minimised by incorporating bar codes into the system s replenishment process.

Síndrome intermedio en el transcurso de una intoxicación por organofosforados a pesar de una infusión continua de pralidoxina / Intermediate syndroem after organophosphate poisoning despite continuous infusion of pralidoxime

En las intoxicaciones agudas por insecticidas organofosforados se produce un síndrome colinérgico debido a un aumento de la aceticolina a nivel sináptico, como consecuencia de una inhibición de la acetilcolinesterasa. En algunos casos, tras la resolución de la sintomatología colinérgica, se presenta el síndrome intermedio, caracterizado por una parálisis de la musculatura proximal y diafragmática. Describimos el caso de un paciente de 67 años que desarrolla un síndrome intermedio tras la ingestión de una cantidad desconocida de oxidemetón-metilo en un intento de autolisis, a pesar de la infusión continuada de pralidoxima a dosis altas. Diversas hipótesis tratan de explicar la etiología del síndrome intermedio (disfunción de la unión neuromuscular, instauración de un tratamiento inadecuado o de inicio tardío con oximas, entre otras). Asimismo, su manifestación se ve condicionada por la persistencia del insecticida organofosforado en el organismo, su estructura química o el tiempo transcurrido entre la ingestión del tóxico y la administración del antídoto

Acute organophosphate poisoning leads to a cholinergic crisis secondary to an acetylcholine rise, developed by an acetylcholinesterase inhibition. In some cases, after the resolution of the initial cholinergic signs and symptoms, an intermediate syndrome occurs, characterized by a delayed development of proximal and diaphragmatic muscle paralysis. We describe a case of a 67-year-old man who developed an intermediate syndrome after oxydemeton-metryl ingestion in a suicide attempt, despite a continuous pralidoxime infusion. Several hypotheses have been developed to explain the aetiology of this intermediate syndrome (neuromuscular junction dysfunction, inadequate poisoning treatment, late beginning of the oxime administration, etc). Intermediate syndrome manifestation will depend on the organophosphate’s organism persistence and its chemical structure, and also on the time elapsed between the poisoning and the antidote administration

Optimización de la calidad del proceso de dispensación de medicamentos en dosis unitaria mediante la implantación del sistema semiautomático Kardex® / No disponible

Objetivo: Evaluar el impacto de la incorporación del sistema semiautomático del almacenaje y dispensación de medicamentos Kardex® sobre la calidad del proceso de llenado de carros de medicamentos en dosis unitaria. Método: Se analiza retrospectivamente la velocidad de llenado de carros de medicamentos en dosis unitaria utilizando el sistema Kardex® (n = 33.946 dispensaciones) comparativamente conel sistema de llenado manual (n = 5.284 dispensaciones); se utilizan y comparan diferentes procedimientos de llenado. Para cada sistema y procedimiento de llenado se obtiene el número de dispensaciones y el tiempo invertido en realizarlas y se calcula la velocidad de proceso expresada en número de dispensaciones por hora. También, se revisan los medicamentos contenidos en el Kardex® y se evalúa la concordancia entre el contenido real y teórico del mismo.Resultados: La velocidad del proceso de llenado de carros,expresada en número dispensaciones por hora, pasa de 394 con el sistema manual (llenado de carros individual, n = 5.284 dispensaciones)a 417, 540 y 592 con Kardex®, realizando el llenado individual (n = 16.530 dispensaciones), o agrupando los carros de2 en 2 (n = 10.369 dispensaciones) o de 3 en 3 (n = 7.047 dispensaciones), respectivamente, en el momento de iniciar el llenado.La revisión del contenido del Kardex® permite detectar un 36% de cubetas con diferencias en cantidad, una cubeta con (..) (AU)

Objective: To evaluate the effect of the incorporation of the semi-automated Kardex® medication storage and dispensing systemon the quality of the filling process of medicine trolleys in unitdoses.Method: The speed of filling medicine trolleys in unit dosesusing the Kardex® system was analysed retrospectively (n =33,946 dispensings) and compared with the manual filling system(n = 5,284 dispensings); different filling procedures were used and compared. For each filling system and procedure, we obtained information for the number of dispensings and the time spent carryingthis out. The speed of the process was calculated as the number of dispensings per hour. In addition, the drugs contained in the Kardex® system were checked and the correspondence between both the actual and the theoretical content was assessed. Results: The speed of the trolley filling process, expressed as the number of dispensings per hour, increased from 394 with the manual system (filling trolleys individually, n = 5,284 dispensings)to 417, 540 and 592 with the Kardex® system when trolleys were filled individually (n = 16,530 dispensings), or grouped in twos (n= 10,369 dispensings) or in threes (n = 7,047 dispensings)respectively, at the start of the filling process. The check of the contents in the Kardex® system detected 36% of trays with differences in quantity, one tray with out of date medication and threetrays which should in theory have been empty and contained (..) (AU)

A method for the automatic characterization of bone architecture in 3D mice microtomographic images.

We developed an automatic method to characterize mice bone architecture from three-dimensional (3D) microtomographic images. The distal metaphyses of the femur of mice were imaged using 3D synchrotron radiation microtomography at the European Synchrotron Radiation Facility (ID19) with a voxel size of 6.65 mum. Within each reconstructed volume, a region of interest was defined and trabecular and cortical bones were automatically separated. Then, 3D morphologic and topologic model-independent parameters quantifying the 3D bone architecture were computed in both regions. The technique was applied to study the response of the C57BL/6J@Ico strain of mice submitted to a model of bone loss by hind limb unloading produced by tail-suspension.

Plant-microbe interactions and the new biotechnological methods of plant disease control.

Plants constitute an excellent ecosystem for microorganisms. The environmental conditions offered differ considerably between the highly variable aerial plant part and the more stable root system. Microbes interact with plant tissues and cells with different degrees of dependence. The most interesting from the microbial ecology point of view, however, are specific interactions developed by plant-beneficial (either non-symbiotic or symbiotic) and pathogenic microorganisms. Plants, like humans and other animals, also become sick, but they have evolved a sophisticated defense response against microbes, based on a combination of constitutive and inducible responses which can be localized or spread throughout plant organs and tissues. The response is mediated by several messenger molecules that activate pathogen-responsive genes coding for enzymes or antimicrobial compounds, and produces less sophisticated and specific compounds than immunoglobulins in animals. However, the response specifically detects intracellularly a type of protein of the pathogen based on a gene-for-gene interaction recognition system, triggering a biochemical attack and programmed cell death. Several implications for the management of plant diseases are derived from knowledge of the basis of the specificity of plant-bacteria interactions. New biotechnological products are currently being developed based on stimulation of the plant defense response, and on the use of plant-beneficial bacteria for biological control of plant diseases (biopesticides) and for plant growth promotion (biofertilizers).

Plant-microbe interactions and the new biotechnological methods of plant disease control / Interacciones plantas–microorganismos y los nuevos métodos biotecnológicos para el control de las enfermedades de las plantas

Plants constitute an excellent ecosystem for microorganisms. The environmental conditions offered differ considerably between the highly variable aerial plant part and the more stable root system. Microbes interact with plant tissues and cells with different degrees of dependence. The most interesting from the microbial ecology point of view, however, are specific interactions developed by plant-beneficial (either non-symbiotic or symbiotic) and pathogenic microorganisms. Plants, like humans and other animals, also become sick, but they have evolved a sophisticated defense response against microbes, based on a combination of constitutive and inducible responses which can be localized or spread throughout plant organs and tissues. The response is mediated by several messenger molecules that activate pathogen-responsive genes coding for enzymes or antimicrobial compounds, and produces less sophisticated and specific compounds than immunoglobulins in animals. However, the response specifically detects intracellularly a type of protein of the pathogen based on a gene-for-gene interaction recognition system, triggering a biochemical attack and programmed cell death. Several implications for the management of plant diseases are derived from knowledge of the basis of the specificity of plant-bacteria interactions. New biotechnological products are currently being developed based on stimulation of the plant defense response, and on the use of plant-beneficial bacteria for biological control of plant diseases (biopesticides) and for plant growth promotion (biofertilizers) (AU)

Las plantas constituyen un excelente ecosistema para los microorganismos. Las condiciones ambientales que ofrecen difieren considerablemente entre la parte aérea de la planta, muy variable, y el sistema de raíces, más estable. Los microorganismos interaccionan con las células y tejidos de la planta con distintos grados de dependencia. Sin embargo, lo más interesante desde el punto de vista de la ecología microbiana son las interacciones específicas desarrolladas por microorganismos patógenos beneficiosos para la planta (tanto las no simbióticas como las simbióticas). Las plantas, como los humanos y otros animales, también enferman, pero han desarrollado una sofisticada respuesta de defensa contra los microorganismos, basada en una combinación de respuestas constitutivas y respuestas inducibles, que pueden ser locales o esparcidas por todos los tejidos y órganos de la planta. La respuesta está mediada por varias moléculas mensajeras que activan genes de respuesta a los patógenos los cuales codifican enzimas o compuestos antimicrobianos, y produce compuestos menos complejos y específicos que las inmunoglobulinas de los animales. Sin embargo, la respuesta detecta de manera específica y en el interior de las células una proteína del patógeno mediante un sistema de reconocimiento de interacción gen a gen, y desencadena un ataque bioquímico y la muerte celular programada. El conocimiento de las bases de la especificidad de las interacciones entre plantas y bacterias repercute en el control de las enfermedades de las plantas. Actualmente se están desarrollando nuevos productos biotecnológicos basados en la estimulación de la respuesta de defensa por parte de las plantas y en el uso de bacterias beneficiosas, que combaten las enfermedades de las plantas (bioplaguicidas) y que estimulan el crecimiento de los vegetales (biofertilizantes). (AU)

Synchrotron radiation microtomography allows the analysis of three-dimensional microarchitecture and degree of mineralization of human iliac crest biopsy specimens: effects of etidronate treatment.

Quantitative microcomputed tomography using synchrotron radiation (SR microCT) was used to assess the effects of a sequential etidronate therapy on both three-dimensional (3D) microarchitecture and degree of mineralization of bone (DMB) in postmenopausal osteoporosis. Thirty-two iliac crest biopsy specimens were taken from 14 patients with osteoporosis (aged 64 +/- 1.8 years) before (baseline) and after 1 year of etidronate treatment, and after 2 years of treatment for four of the patients. The samples were imaged at high spatial resolution (voxel size = 10 microm) using the microtomography system developed at the European Synchrotron Radiation Facility (ESRF), Grenoble, France. Three-dimensional microarchitecture parameters were calculated and compared with those obtained from conventional histomorphometry. In addition, the DMB was evaluated also in 3D. No significant statistical changes regarding bone mass and structural parameters were observed in histomorphometry or 3D analyses. The distribution of the DMB in cortical and trabecular bone showed a trend to a shift toward highest mineralization values after 1 year of etidronate treatment (3.88% and 1.24% in cortical and trabecular bone, respectively). This trend was more evident after 2 years. The study also showed that SR microCT is an accurate technique and the only one for quantifying both the mineralization and the microarchitecture of bone samples at the same time in 3D.

Optical correlation by use of partial phase-only modulation with VGA liquid-crystal displays.

The development of liquid-crystal panels for use in commercial equipment has been aimed at improving the pixel resolution and the display efficiency. These improvements have led to a reduction in the thickness of such devices, among other outcomes, that involves a loss in phase modulation. We propose a modification of the classical phase-only filter to permit displays in VGA liquid-crystal panels with a constant amplitude modulation and less than a 2pi phase modulation. The method was tested experimentally in an optical setup.