Covid-19 en trabajadores de la Salud: Experiencia en la Residencia de Pediatría de un hospital de La Plata, Argentina / Covid-19 in health workers: Experience in the Pediatric Residence of a hospital in La Plata, Argentina

Introducción: Los trabajadores de la salud (TS) poseen la mayor exposición laboral al contagio SARS-CoV-2. Los residentes forman parte fundamental de los servicios de salud por lo que no se encuentran exentos del impacto físico, psíquico, social y económico negativo producido por la pandemia por COVID-19. Objetivo: : Describir el impacto epidemiológico de la enfermedad profesional por COVID-19 en médicos residentes de pediatría. Material y métodos: Estudio descriptivo de corte transversal en médicos residentes de pediatría del H.I.A.E.P "Sor María Ludovica". El período comprendido en el estudio fue del 01/10/2020 al 30/09/2021. Se evaluaron los siguientes datos: género, edad, antecedentes personales, vacunación, cuadro clínico, métodos diagnósticos, aislamientos epidemiológicos, evolución y licencias tramitadas. Los datos fueron registrados por la jefatura de residentes. Resultados: 143 casos sospechosos de COVID-19, de ellos 30 resultaron confirmados de COVID-19. La edad media de los enfermos fue de 31 años (26-46 años) de los cuales 14 (47%) no estaban vacunados contra SARS COV-2, 11 (36%) estaban completamente inmunizados y 5 (17%) tenían calendario incompleto. 2 casos (6,6%) reportaron comorbilidad previa. Se realizaron pruebas de laboratorio en 130 de los 143 casos. 13 casos se descartaron por criterio clínico. La tasa de positividad fue 23,1%. 26 casos fueron confirmados por laboratorio y 4 casos mediante criterio clínico epidemiológico. Todos los casos fueron leves y evolucionaron favorablemente. Fueron gestionadas 326 licencias relacionadas a la pandemia por COVID-19 que significaron la pérdida de 2.830 días laborales. Conclusión: En el presente estudio se evidenció una alta tasa de incidencia de COVID-19 en residentes de pediatría en un año: 23,1%

Introduction: Health workers (HCWs) have the highest occupational exposure to SARS-CoV-2 contagion. Residents are a fundamental part of health services, so they are not exempt from the negative physical, psychological, social and economic impact caused by the COVID-19 pandemic. Objectives: To describe the epidemiological impact of the occupational disease by COVID-19 in resident pediatricians. Material and methods: Descriptive cross-sectional study in pediatric residents of the H.I.A.E.P "Sor María Ludovica". The period covered by the study was from 10/01/2020 to 09/30/2021. The following data were evaluated: gender, age, personal history, vaccination, clinical picture, diagnostic methods, epidemiological isolates, evolution and licenses processed. The data was recorded by the head of residents. Results: 143 suspected cases of COVID-19, of which 30 were confirmed to be COVID-19. The mean age of the patients was 31 years (26-46 years), of which 14 (47%) were not vaccinated against SARS COV.-2, 11 (36%) were fully immunized and 5 (17%) had an incomplete schedule. 2 cases (6.6%) reported previous comorbidity. Laboratory tests were performed in 130 of the 143 cases. 13 cases were ruled out based on clinical criteria. The positivity rate was 23.1%. 26 cases were confirmed by laboratory and 4 cases by clinical epidemiological criteria. All cases were mild and evolved favorably. 326 licenses related to the COVID-19 pandemic were managed, which meant the loss of 2,830 working days. Conclusion: In the present study, a high rate of incidence of COVID-19 was evidenced in pediatric residents in one year: 23.1%

Reline aqueous solutions behaving as liquid mixtures of H-bonded co-solvents: microphase segregation and formation of co-continuous structures as indicated by Brillouin and 1H NMR spectroscopies.

Deep eutectic solvents (DESs) offer a suitable alternative to conventional solvents in terms of both performance and cost-effectiveness. Some DESs also offer certain green features, the greenness of which is notoriously enhanced when combined with water. Aqueous DES dilutions are therefore attracting great attention as a novel green medium for biotechnological processes, with the aqueous dilutions of reline - a DES composed of urea and choline chloride - being one of the most studied systems. Despite their macroscopic homogeneous appearance, both 1H NMR spectroscopic studies and molecular dynamics simulations have revealed the occurrence of certain dynamic heterogeneity at a microscopic molecular level. Ultrasonic measurements were also used with the aim of getting further insights but nonconclusive results were obtained. Herein, we have studied aqueous reline dilutions by Brillouin spectroscopy given its proved suitability for detecting local structure rearrangements in liquid mixtures of H-bonded co-solvents. Brillouin spectroscopy revealed the formation of a co-continuous structure resulting from local structure rearrangements and micro-segregation into aqueous and DES phases. Interestingly, there is agreement between 1H NMR and Brillouin spectroscopy when pointing to the DES content where microphase segregation and formation of co-continuous structures occurred.

Impact of an enhanced recovery after surgery programme in radical cystectomy. A cohort-comparative study. / Impacto de un programa de recuperación intensificada en cistectomía radical. Estudio comparativo de cohortes.

OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared. RESULTS: No statistically significant differences in overall complication rate were found (73.171 vs. 77.32%; OR 1.25, 95% CI 0.54-2.981; P=.601) nor in Clavien-Dindo>2 complications (41.463 vs. 42.268%; OR 1.033, 95% CI 0.492-2.167; P=.93), mortality, lengths of stays readmission and reoperation rates. The need for nasogastric tube insertion was lower in the ERAS group (43.902 vs. 78.351%; OR 4.624, 95% CI 2.112-10.123; P<.0001), as well as the need for total parenteral nutrition (26.829 vs. 34.021%; OR 12.234, 95% CI 5.165-28.92; P<.0001), and time under endotracheal intubation since anaesthesia induction (median [IRQ]=325 (285-355) vs. 540 (360-600) min; P<.0001). CONCLUSION: Enhanced recovery programs in radical cystectomy decrease interventionism on the patient without increasing morbidity and mortality.

Comparison of the anogenital distance and anthropometry of the perineum in patients with and without pelvic organ prolapse. / Comparación de la distancia anogenital y antropometría del periné en pacientes con y sin prolapso de órganos pélvicos.

OBJECTIVES: To determine whether there are differences in the anthropometric measures of the perineum for women with symptomatic pelvic organ prolapse who are candidates for surgery, with or without urinary incontinence, and for patients without pelvic floor dysfunction. The main objective was to measure the anogenital distance in its 2 variants: anoclitoral and anofourchette. The anogenital distance appears to be determined prenatally and is influenced by the intrauterine hormonal environment. The secondary objective was to measure the length of the genital hiatus, the perineal body and the distance between the 2 ischial tuberosities. MATERIAL AND METHODS: An observational case-control study was conducted with 58 patients. The cases (n=22) were patients with stages >II 2 in the Baden-Walker classification system. The controls were patients with normal pelvic floors. Measurements were performed with a digital calliper. The patients' tocogynecological history, lifestyle habits and risk factors were recorded. RESULTS: The case patients had a significantly shorter anogenital anofourchette distance than that of the control patients (P=.001), a significantly longer anogenital anoclitoral distance than the control patients (P=.0001) and a significantly longer genital hiatus length than the control patients (P=.02). CONCLUSIONS: This was an observational study with a small sample. We cannot determine whether the difference in these distances are caused by or are the result of this disease. Given that the anogenital distance appears to be determined prenatally, we question whether this changed distance could be a risk factor for developing pelvic floor dysfunction.

Prevalence of endometriosis in epithelial ovarian cancer. Analysis of the associated clinical features and study on molecular mechanisms involved in the possible causality.

PURPOSE OF INVESTIGATION: To determine the prevalence of endometriosis in patients with epithelial ovarian cancer and explore the differences between women with endometrioid and clear-cell histologic subtypes with and without associated endometriosis. MATERIALS AND METHODS: The medical charts of 496 patients with epithelial ovarian cancer at the Hospital Virgin de la Arrixaca (Murcia, Spain) between 1971 and 2010 were reviewed. RESULTS: Endometriosis was present in 27 (5.4%) of the 496 cases (p < 0001), and was associated with the endometrioid histotype in 13/45 cases (29%) and with the clear cell histotype in 7/22 (32%). The prevalence of an association with endometriosis according to histologic type was 28.8% (13/45) for endometrioid carcinoma and 31.8% (7/22) for clear-cell carcinoma. CONCLUSION: Both endometrioid and clear-cell ovarians tumours are associated with pelvic endometriosis. Patients with endometiosis associated ovarian cancer differ from non-endometiosis associated ovarian cancer in their clinical characteristics.

Use of eutectic mixtures for preparation of monolithic carbons with CO2-adsorption and gas-separation capabilities.

With global warming becoming one of the main problems our society is facing nowadays, there is an urgent demand to develop materials suitable for CO2 storage as well as for gas separation. Within this context, hierarchical porous structures are of great interest for in-flow applications because of the desirable combination of an extensive internal reactive surface along narrow nanopores with facile molecular transport through broad "highways" leading to and from these pores. Deep eutectic solvents (DESs) have been recently used in the synthesis of carbon monoliths exhibiting a bicontinuous porous structure composed of continuous macroporous channels and a continuous carbon network that contains a certain microporosity and provides considerable surface area. In this work, we have prepared two DESs for the preparation of two hierarchical carbon monoliths with different compositions (e.g., either nitrogen-doped or not) and structure. It is worth noting that DESs played a capital role in the synthesis of hierarchical carbon monoliths not only promoting the spinodal decomposition that governs the formation of the bicontinuous porous structure but also providing the precursors required to tailor the composition and the molecular sieve structure of the resulting carbons. We have studied the performance of these two carbons for CO2, N2, and CH4 adsorption in both monolithic and powdered form. We have also studied the selective adsorption of CO2 versus CH4 in equilibrium and dynamic conditions. We found that these materials combined a high CO2-sorption capacity besides an excellent CO2/N2 and CO2/CH4 selectivity and, interestingly, this performance was preserved when processed in both monolithic and powdered form.

3D free-standing porous scaffolds made of graphene oxide as substrates for neural cell growth.

The absence of efficient therapies for the treatment of lesions affecting the central nervous system encourages scientists to explore new materials in an attempt to enhance neural tissue regeneration while preventing inhibitory fibroglial scars. In recent years, the superlative properties of graphene-based materials have provided a strong incentive for their application in biomedicine. Nonetheless, a few attempts to date have envisioned the use of graphene for the fabrication of three-dimensional (3D) substrates for neural repair, but none of these involve graphene oxide (GOx) despite some attractive features such as higher hydrophilicity and versatility of functionalization. In this paper, we report novel, free-standing, porous and flexible 3D GOx-based scaffolds, produced by the biocompatible freeze-casting procedure named ISISA, with potential utility in neural tissue regeneration. The resulting materials were thoroughly characterized by Fourier-transform infrared, Raman, and X-ray photoelectron spectroscopies and scanning electron microscopy, as well as flexibility testing. Embryonic neural progenitor cells were then used to investigate adhesion, morphology, viability, and neuronal/glial differentiation. Highly viable and interconnected neural networks were formed on these 3D scaffolds, containing both neurons and glial cells and rich in dendrites, axons and synaptic connections, and the results are in agreement with those obtained in initial studies performed with two-dimensional GOx films. These results encourage further investigation in vivo on the use of these scaffolds as guide substrates to promote the repair of neural injuries.

Reproductive outcome after uterine-sparing surgery for endometrial stromal sarcoma.

► This is the second report of pregnancy following endometrial stromal sarcoma (ESS). ► The role of adnexectomy is controversial in stage I ESS. ► Adnexectomy does not appear to affect survival in stage I ESS.

Perfil de toxicidad y adherencia del esquema farmacoterapéutico gemcitabina-carboplatino en cáncer de pulmón no microcítico / Toxicity Profile and Adherence to the Pharmacotherapeutic Regimen of Gemcitabine–carboplatin in Non-small Cell Lung Cancer

Objetivo Analizar la relación entre las dosis administradas de gemcitabina-carboplatino (GEM-CARBO) y la incidencia y grado de toxicidad, hematológica y renal, y la adherencia al tratamiento en pacientes con cáncer de pulmón no microcítico. Métodos Estudio retrospectivo de 37 meses de duración. El conjunto mínimo de datos para realizar el seguimiento de los pacientes se obtuvo con ayuda del programa informático Farmis-Oncofarm® y de las historias clínicas y farmacoterapéuticas. La toxicidad hematológica se evaluó de acuerdo con la Common Toxicity Criteria 3.0. La toxicidad renal se valoró a partir de los datos de concentración sérica de creatinina y el aclaramiento de creatinina. Resultados Se han incluido en el estudio 31 pacientes a los que se les administraron un total de 122 ciclos. La incidencia de anemia y neutropenia grado III fue de un 34,0 y un 30,8%, respectivamente, de trombocitopenia de grado III del 3,8% y de grado IV del 7,7%. No se ha identificado ningún caso de toxicidad renal. El 65,0% de los pacientes recibieron más del 85,0% de la dosis de carboplatino teórica planeada y el 58,0% de los pacientes recibieron más del 85,0% de la dosis de gemcitabina teórica planeada. Se retrasó la administración en el 18,0% de los ciclos prescritos. Conclusiones La indicación y prescripción del esquema GEM-CARBO se ha ajustado con unas evidencias científicas sólidas, pero su toxicidad hematológica ha limitado su uso y ha dificultado la administración de la intensidad de dosis prevista comprometiendo la efectividad del tratamiento (AU)

Objective To analyse the relationship between doses of gemcitabine–carboplatin (GEM-CARBO) administered and incidence and level of haematological and renal toxicity, and the adherence to the treatment in patients with non-small cell lung cancer. Methods Retrospective study, which lasted for 37 months. We were able to obtain the minimum set of data needed to carry out the follow-up with the help of Farmis-Oncofarm® software and the medical and pharmacotherapeutic records. The haematological toxicity was assessed in accordance with the Common Toxicity Criteria 3.0. Renal toxicity was evaluated using serum creatinine levels and creatinine clearance. Results Thirty-one patients were included in the study who were administered a total of 122 cycles. There was a 34.0% and 30.8% incidence of anaemia and grade 3 neutropenia, respectively. There was also a 3.8% and 7.7% incidence of grade 3 and grade 4 thrombocytopenia, respectively. No cases of renal toxicity were found. 65.0% of patients received more than 85.0% of the planned theoretical dosage of carboplatin and 58% of patients received more than 85.0% of the planned theoretical dosage of gemcitabine. Administration was delayed in 18.0% of the cycles prescribed. Conclusions The indication and prescription of the GEM-CARBO regimen was adjusted in accordance with solid scientific evidence, but its haematological toxicity limited its use and made it difficult to maintain the dose intensity foreseen in the study. This compromised the effectiveness of the treatment (AU)

Toxicity profile and adherence to the pharmacotherapeutic regimen of gemcitabine-carboplatin in non-small cell lung cancer.

OBJECTIVE: To analyse the relationship between doses of gemcitabine-carboplatin (GEM-CARBO) administered and incidence and level of haematological and renal toxicity, and the adherence to the treatment in patients with non-small cell lung cancer. METHODS: Retrospective study which lasted for 37 months. We were able to obtain the minimum set of data needed to carry out the follow-up with the help of Farmis-Oncofarm(®) software and the medical and pharmacotherapeutic records. The haematological toxicity was assessed in accordance with the Common Toxicity Criteria 3.0. Renal toxicity was evaluated using serum creatinine levels and creatinine clearance. RESULTS: Thirty-one patients were included in the study who were administered a total of 122 cycles. There was a 34.0% and 30.8% incidence of anaemia and grade 3 neutropaenia, respectively. There was also a 3.8% and 7.7% incidence of grade 3 and grade 4 thrombocytopaenia, respectively. No cases of renal toxicity were found. 65.0% of patients received more than 85.0% of the planned theoretical dosage of carboplatin and 58% of patients received more than 85.0% of the planned theoretical dosage of gemcitabine. Administration was delayed in 18.0% of the cycles prescribed. CONCLUSIONS: The indication and prescription of the GEM-CARBO regimen was adjusted in accordance with solid scientific evidence, but its haematological toxicity limited its use and made it difficult to maintain the dose intensity foreseen in the study. This compromised the effectiveness of the treatment.

Experimental contributions to the study of the embryology of the vagina.

BACKGROUND: Acién's hypothesis, deduced from patients with malformations of the female genital tract, especially those with renal agenesis and ipsilateral blind hemivagina, affirms the embryology of the human vagina as deriving from the Wolffian ducts and the Müllerian tubercle and could explain the embryological origin of all the female genital malformations reported. In this study, we investigated the hypothesis in rats. METHODS: Twenty-five pregnant rats were used to analyse female embryos (64) from day 15 (stage indifferent) to day 20 postcoitum (vagina completely formed). We performed transverse and longitudinal sections of embryos, haematoxylin-eosin tinction and immunohistochemical staining using markers specific to Wolffian derivatives. We also analysed the presence of these markers in the vagina of four adult rats. RESULTS: The Müller ducts converge until they fuse into one tube, but caudally they diverge and finally they fuse with the 'urogenital sinus bulbs' that are actually the distal portion of the Wolffian ducts according to the immunohistochemical marking with GZ1 and GZ2. The Müllerian tubercle is observed between those elements. Then, the immunohistochemical staining can be seen all along the completely formed vagina, which is also observed in the vagina of the adult rat. CONCLUSION: We prove the participation of Müller tubercle and Wolffian ducts in the formation of the vagina in rats, so we confirm experimentally Acién's hypothesis about the human vagina embryology.

Prevalencia de fatores ambientais associados a quedas em idosos residentes na comunidade em Sao Paulo, SP

O objetivo deste estudo foi determinar a prevalencia de fatores ambientais de risco para quedas em idosos que vivem na comunidade e sua associacao com idosos que nunca cairam e com os que caem recorrentemente. Foi realizado um estudo transversal com 87 idosos com idade superior a 65 anos morando na comunidade e participantes de um estudo coorte prospectivo. Uma avaliacao ambiental padronizada foi realizada nos domicilios de 53 idoso que cairam recorrentemente e de 34 idosos que nunca havia caido. Foi observada alta prevalencia de riscos ambientais nos domicilios dessa populacao: piso escorregadio (88,5 por cento), presenca de tapetes na sala (62 por cento),armarios inacessiveis na cozinha (87,4 por cento) e ausencia de iluminacao noturna (44,8 por cento). Nao houve domicilio livre de riscos, sendo a media encontrada de 22 riscos/domicilios de 47 avaliados. So houve associacao entre riscos ambientais e idoso que cairam recorrentemente para a presenca de interruptores de luz inacessivel em todos os comodos. Tapetes nos banheiros, presenca de escadas com riscos e a atitude de subir em um banco para alcancar objetos foram mais prevalentes entre os idosos que nunca cairam. Os domicilios apresentam muitos riscos ambientais. Nao foi encontrada associacao importante entre a presenca dos riscos e idoos que cairam. Idosos que nunca cairam parecem adotar com mais frequencia comportamentos de risco diante dos atributos ambientes

[Malnutrition evaluation in obese patients of both sexes on a very low caloric content diet]. / Evaluación de la malnutrición en pacientes obesos de ambos sexos tratados con dieta de muy bajo contenido calórico.

We have evaluated the effectiveness of a very low caloric content diet (VLCD) during 6 weeks in patients with severe obesity (grades II and III). Twenty-seven men and 61 women were selected for evaluation of anthropometric (weight, body mass index [BMI], waist, hip, C/c, fatty weight and intra-abdominal fatty area) and biochemical (creatinine-height index [CHI], albumin, transferrin, retinol binding protein [RBP], prealbumin, C3, and lymphocytes count) malnutrition parameters, at the beginning and after 6 weeks of treatment with VLCD. In men we found a significant decrease of weight, BMI, waist, hip, fatty weight, and intra-abdominal fatty area. In women the decrease of weight, BMI, hip, and fatty weight was also significant. We found baseline malnutrition in 7.4% of men and in 14.7% of women, and after the treatment in 22.2% of men and in 34.4% of women (p < 0.05). With regard to the biochemical parameters of protein malnutrition, only men showed significant decrease in the CHI and only women showed significant decrease in transferrin, RBP, prealbumin, and C3. In conclusion, we can state that different types of VLCD are effective for weight loss in severe obese subjects. However, within a period of follow-up of 6 weeks we have detected the presence of protein malnutrition, especially in women, being in these patients affected the visceral compartment while in men the muscular compartment is affected.

Diagnóstico de las alteraciones del metabolismo hidrocarbonado durante la gestación / The diagnostic of the alterations of the carbohydrate metabolism during the gestation

Definida la diabetes gestacional como toda intolerancia a los hidratos de carbono de intensidad variable, de comienzo o primer reconocimiento durante la gestación, su diagnóstico y tratamiento oportunos evita las frecuentes complicaciones neonatales asociadas a este trastorno. La prevalencia de este proceso oscila entre el 1 al 14 por ciento de los embarazos, dependiendo de la población estudiada y representa el 90 por ciento de todos los embarazos complicados con diabetes , en nuestro país se sitúa entre el 10’7 y el 16 por ciento. Se revisan los diferentes aspectos de la diabetes gestacional tanto para el feto como para la gestante, destacando en el primer aspecto que de tratarse oportunamente la morbilidad perinatal es similar a la de la población normal y en el segundo aspecto el mayor número de cesáreas y el mayor riesgo para la madre de padecer diabetes mellitus de tipo 2. Se revisan los diferentes criterios de diabetes gestacional y se establece el algoritmo diagnóstico y terapéutico del proceso, mediante las pruebas de screening y las pruebas diagnósticas (AU)

Hepatitis colestásica por metimazol / Methimazole-induced cholestatic hepatitis

Los antitiroideos de síntesis son fármacos de uso muy frecuente en el tratamiento del hipertiroidismo. Presentan con frecuencia reacciones adversas en la piel y es también muy conocida su capacidad, mucho más rara, de provocar agranulocitosis. También es habitual que puedan causar elevaciones asintomáticas y autolimitadas de transaminasas; sin embargo, son muchos menos los casos descritos de hepatotoxicidad con repercusiones clínicas. Presentamos el caso de una paciente con hepatitis tóxica aguda secundaria a la toma de metimazol, que se manifestó como ictericia colestásica (AU)

The conformation of serum albumin in solution: a combined phosphorescence depolarization-hydrodynamic modeling study.

There is a striking disparity between the heart-shaped structure of human serum albumin (HSA) observed in single crystals and the elongated ellipsoid model used for decades to interpret the protein solution hydrodynamics at neutral pH. These two contrasting views could be reconciled if the protein were flexible enough to change its conformation in solution from that found in the crystal. To investigate this possibility we recorded the rotational motions in real time of an erythrosin-bovine serum albumin complex (Er-BSA) over an extended time range, using phosphorescence depolarization techniques. These measurements are consistent with the absence of independent motions of large protein segments in solution, in the time range from nanoseconds to fractions of milliseconds, and give a single rotational correlation time phi(BSA, 1 cP, 20 degrees C) = 40 +/- 2 ns. In addition, we report a detailed analysis of the protein hydrodynamics based on two bead-modeling methods. In the first, BSA was modeled as a triangular prismatic shell with optimized dimensions of 84 x 84 x 84 x 31.5 A, whereas in the second, the atomic-level structure of HSA obtained from crystallographic data was used to build a much more refined rough-shell model. In both cases, the predicted and experimental rotational diffusion rate and other hydrodynamic parameters were in good agreement. Therefore, the overall conformation in neutral solution of BSA, as of HSA, should be rigid, in the sense indicated above, and very similar to the heart-shaped structure observed in HSA crystals.

[Usefulness of cholinesterase determination in ascitic fluid in the differential diagnosis of ascites]. / Utilidad de la determinación de la colinesterasa en líquido ascítico en el diagnóstico diferencial de la ascitis.

BACKGROUND: Cholinesterase is an enzyme mainly synthesized in the liver that might play a role in the differential diagnosis of ascites. We prospectively compared the sensitivity, specificity and diagnostic usefulness of the ascites cholinesterase and the classical parameters, ascites total protein concentration and serum-ascites albumin gradient in the differential diagnosis of ascites. In addition, we evaluated the relationship between those parameters and the degree of liver failure. METHODS: A total of 91 patients with ascites were analyzed. According the final diagnosis, patients were classified in two groups, patients with signs of portal hypertension [n = 78] (60 with chronic liver disease, 5 chronic liver disease and hepatocellular carcinoma, 3 chronic liver disease and spontaneous bacterial peritonitis, 3 chronic liver disease and secondary peritonitis, 7 malignancy with liver involvement) and patients with no signs of portal hypertension [n = 13] (12 patients with peritoneal neoplasia without liver involvement and 1 tuberculous peritonitis). RESULTS: The sensitivity of the test for detecting portal hypertensive ascites was lowest for ascites cholinesterase less than 600 U/L (71.7%); intermediate with ascites total protein concentration less than 25 g/l (87.2%) and highest with serum-ascites albumin gradient at least 11 g/l (93.6%). The specificity for ruling out portal hypertensive ascites was 100 percent for ascites total protein > or = 25 g/l and ascites cholinesterase > or = 600 U/L and, 76.9 percent for serum-ascites albumin gradient < 11 g/l). Diagnostic efficiency (percentage of patients accurately classified) was greater for serum-ascitis albumin gradient (91.2%; IC95: 83-95.8), and lower for ascites total protein content (89%, IC95: 80.3-94.3) and, ascites cholinesterase (75.8%; IC95: 65.5-83.9). Ascites cholinesterase showed a significant relationship (p = 0.007) with the degree of liver failure measured by Pugh's classification. CONCLUSION: Serum-ascites albumin gradient was the test with best performance characteristics to identify patients with ascites related with portal hypertension. Our results suggest that ascites cholinesterase is more associated with the degree of liver failure than with the presence of portal hypertension.

Utilidad de la determinación de la colinesterasa en líquido ascítico en el diagnóstico diferencial de la ascitis / Usefulness of ascities cholinesterase in the differential diagnosis of ascities

En el presente estudio hemos comparado de forma prospectiva la sensibilidad, especificidad y la eficiencia diagnóstica de la colinesterasa en líquido ascítico, la concentración de proteínas totales en líquido ascítico y el gradiente suero-ascitis de albúmina en el diagnóstico diferencial de la ascitis. Asimismo hemos evaluado la asociación entre los parámetros descritos y el grado de insuficiencia hepática. Un total de 91 pacientes consecutivos con ascitis fueron analizados. Los pacientes fueron clasificados según su diagnóstico final en dos grandes grupos: pacientes con signos de hipertensión portal [n=78] (60 pacientes con cirrosis hepática como único hallazgo, 5 con cirrosis hepática y carcinoma hepatocelular, 6 con cirrosis hepática y peritonitis bacteriana espontánea o secundaria y 7 con neoplasia con metástasis hepáticas) y pacientes sin signos de hipertensión portal [n=13] (12 pacientes con neoplasia sin afectación hepática y uno con tuberculosis peritoneal). Los pacientes con cirrosis hepática fueron agrupados por grado de insuficiencia hepática según la clasificación de Pugh. Resultados: La sensibilidad para detectar ascitis asociada a hipertensión portal fue baja para la colinesterasa en líquido ascítico £ de 600 U/L (71,7 porciento; IC95: 60,3-81,1); intermedia para concentración de proteínas totales en líquido ascítico 600 U/L (100 porciento, IC95: 75,3-100) y para concentración de proteínas totales en líquido ascítico =25 g/l (100 porciento; IC95: 75,3-100) y menor para el gradiente suero-ascitis de albúmina < 11 g/l (76,9; IC95: 46,1-93,7). La eficiencia diagnóstica (porcentaje de pacientes correctamente clasificados) fue máxima para el gradiente suero-ascitis de albúmina (91,2 porciento; IC95 83,0-95,8) y menor para la concentración de proteínas en líquido ascítico (89 porciento, IC95: 80,3-94,3) y para la colinesterasa en líquido ascítico (75,8 porciento; IC95: 65,5-83,9). La colinesterasa en líquido ascítico mostró una asociación significativa (p=0,007) con el grado de insuficiencia hepática. Conclusión: El gradiente suero-ascitis de albúmina fue la prueba con mejor rendimiento para identificar los pacientes con ascitis debida a hipertensión portal (AU)

Kinetic spectroscopy of erythrosin phosphorescence and delayed fluorescence in aqueous solution at room temperature.

The photophysics and polarization of the phosphorescence and delayed fluorescence of erythrosin in conditions compatible with the current biological applications of the dye (aqueous buffers at pH 7.4 at ambient temperatures) and in ethanol have been studied as a function of dye concentration (10(-7)-10(-5) M) and temperature (245-333 K). The emission decay is strictly single exponential and the detailed kinetic analysis of all the rate processes connected with the emitting T1 state showed that (1) the lowering of the emission lifetime at the higher temperatures is due to a very efficient self-quenching process, (2) the back intersystem crossing rate T1-->S1 is temperature dependent (delta ETS approximately 7 kcal mol-1) but the T1-->S0 is not (Ea < 0.1 kcal mol-1) and (3) both intersystem crossing processes are very sensitive to solvent polarity, which accounts for the solvent dependence of the phosphorescence yield and lifetime. The high value of the phosphorescence anisotropy (r0 = 0.25 +/- 0.006) is independent of the excitation and emission wavelengths, and its evolution in time accurately reflects the rotational restrictions in solid solutions. The relevance of these findings to studies with protein-dye conjugates is also outlined to facilitate the design and interpretation of phosphorescence depolarization experiments that probe the microsecond-ms dynamics of biomolecules and supramolecular systems.

Proton-transfer lasers from solid polymeric chains with covalently bound 2-(2'-hydroxyphenyl) benzimidazole groups.

The lasing properties of a number of newly synthesized 2-(2'-hydroxyphenyl) benzimidazole derivatives copolymerized with methyl methacrylate or dissolved in poly (methyl methacrylate) and pumped with an N(2) laser are reported. The radiation mechanism is based on the intramolecular proton-transfer in the electronic excited state. Both the lasing efficiency and the dye photostability increase significantly when the proton-transfer chromophore is covalently bound to the polymeric chain, and energy-conversion efficiencies comparable to those obtained in liquid solution are demonstrated.