Multiepitope Dendrimeric Antigen-Silica Particle Composites as Nano-Based Platforms for Specific Recognition of IgEs.

ß-lactam antibiotics (BLs) are the drugs most frequently involved in drug hypersensitivity reactions. However, current in vitro diagnostic tests have limited sensitivity, partly due to a poor understanding of in vivo drug-protein conjugates that both induce the reactions and are immunologically recognized. Dendrimeric Antigen-Silica particle composites (DeAn@SiO2), consisting on nanoparticles decorated with BL-DeAns are promising candidates for improving the in vitro clinical diagnostic practice. In this nano-inspired system biology, the synthetic dendrimer plays the role of the natural carrier protein, emulating its haptenation by drugs and amplifying the multivalence. Herein, we present the design and synthesis of new multivalent mono- and bi-epitope DeAn@SiO2, using amoxicillin and/or benzylpenicillin allergenic determinants as ligands. The homogeneous composition of nanoparticles provides high reproducibility and quality, which is critical for in vitro applications. The suitable functionalization of nanoparticles allows the anchoring of DeAn, minimizing the nonspecific interactions and facilitating the effective exposure to specific IgE; while the larger interaction area increments the likelihood of capturing specific IgE. This achievement is particularly important for improving sensitivity of current immunoassays since IgE levels in BL allergic patients are very low. Our data suggest that these new nano-based platforms provide a suitable tool for testing IgE recognition to more than one BL simultaneously. Immunochemical studies evidence that mono and bi-epitope DeAn@SiO2 composites could potentially allow the diagnosis of patients allergic to any of these drugs with a single test. These organic-inorganic hybrid materials represent the basis for the development of a single screening for BL-allergies.

Effects of flow and colony morphology on the thermal boundary layer of corals.

The thermal microenvironment of corals and the thermal effects of changing flow and radiation are critical to understanding heat-induced coral bleaching, a stress response resulting from the destruction of the symbiosis between corals and their photosynthetic microalgae. Temperature microsensor measurements at the surface of illuminated stony corals with uneven surface topography (Leptastrea purpurea and Platygyra sinensis) revealed millimetre-scale variations in surface temperature and thermal boundary layer (TBL) that may help understand the patchy nature of coral bleaching within single colonies. The effect of water flow on the thermal microenvironment was investigated in hemispherical and branching corals (Porites lobata and Stylophora pistillata, respectively) in a flow chamber experiment. For both coral types, the thickness of the TBL decreased exponentially from 2.5 mm at quasi-stagnant flow (0.3 cm s(-1)), to 1 mm at 5 cm s(-1), with an exponent approximately 0.5 consistent with predictions from the heat transfer theory for simple geometrical objects and typical of laminar boundary layer processes. Measurements of mass transfer across the diffusive boundary layer using O(2) microelectrodes revealed a greater exponent for mass transfer when compared with heat transfer, indicating that heat and mass transfer at the surface of corals are not exactly analogous processes.

Cuidados enfermeros del paciente con resección pulmonar / Nursing care of patients who have undergone lung resection

La cirugía de pulmón representa un importante riesgo quirúrgico, con una mortalidad entre el 5 y el 20%, ya que la apertura de la cavidad torácica constituye por si sola un intervención con repercusión sistémica. Con el propósito de mejorar los resultados de los pacientes que pasan por este proceso y facilitar la adaptación a la nueva vida de la persona operada,se ha elaborado un plan de cuidados enfermeros que contempla el estado físico, emocional y la necesidad de aprendizaje educacional.Se especifican y fundamentan los cuidados enfermeros en las fases de preoperatorio y postoperatorio y se describe y fundamenta la importancia de la valoración y control de signos y síntomas, drenajes y catéteres, para la prevención de complicaciones o en su caso para la detección precoz de las mismas.Se incluye un apartado específico sobre la importancia del tratamiento del dolor en los pacientes durante el postoperatorio y su asociación con las complicaciones potenciales del proceso quirúrgico, se especifican las recomendaciones al alta hospitalaria (AU)

Lung surgery entails an important surgical risk, with mortality ranging between 5% and 20%, due to the fact that the opening of the thoracic cavity,in itself, constitutes and intervention with systemic repercussions.In order to improve the outcome in patients who have undergone this procedure and to facilitate adjustment to their new life after the operation,a nursing care plan has been elaborated. This plan takes into account the physical and emotional state of the patient and the need for educational learning.Nursing care guidelines and principles during the preoperative and postoperative stages as well as the importance of assessing and controlling signs and symptoms, drainage lines, and catheters are described for the prevention and early detection of complications.The paper includes a specific section on the relevance of pain management during the postoperative course and its association with potential complications of the surgical procedure as well as postoperative instructions for the patient to follow at the time of discharge (AU)

[Surgical treatment versus tracheostomy of the laryngeal stenosis in children]. / Cirugía versus traqueostomía en las estenosis laríngeas pediátricas.

Incidence of pediatric laryngeal stenosis has increased due to better Intensive Care Units. The medical records of the patients with laryngeal stenosis treated in the hospital between 1990 and 1995 were reviewed, analyzing the type of lesion, ethiologic factors, surgical technique employed and post-op result. The surgical technique was chosen conditioned by the age, weight of the patient, grade of the stenosis according to Cotton's classification and presence or absence of respiratory distress. 48 patients had laryngeal stenosis. 2 of them had acute glottic edema (4%) and 45 subglottic stenosis (96%), most of them after long term endotracheal intubation, 34 cases (75.5%). 19 of these occurred in the neonatal period. 7 cases (15.5%) were congenital stenosis (2 subglottic membranes, 1 subglottic cyst and 4 true congenital subglottic stenosis). 5 cases were a miscelanea. We found 13 grade I cases (29%), grade II 16 cases (35%) and grade III 12 (27%). No grade IV were seen. 8 patients (18%) had gastro-esophageal reflux, 5 of them required Nissen's funduplication before airway surgery. 12 patients followed medical treatment (27%), all of them grades I and II, with good results. Endoscopic treatment was done in 6 patients (13%), with good results in all but one that required a surgical approach. The anterior cricothiroid split was done in 7 patients (15%), all of them under 5 months of age. Good results were obtained in 71.4 percent of the patients. 9 cases (20%) underwent an anterior largingotracheoplasty with costal cartilage graft with good results in 88.9 percent of the patients. Anterior and posterior cartilage graft after double laringotracheoplasty was done to 8 patients (18%). One of them developed a subglottic sinequiae which was solved endoscopically, and another patient evolved to restenosis. 20 patients had a tracheostomy. All but four were decanulated in 11.7 +/- 12.3 (4-54) weeks. Mortality rate associated with the surgical technique has been zero, with excellent results in 82.5 percent of the series. The new surgical techniques developed in recent years for laringotracheal stenosis in childhood have made unnecessary the use of permanent tracheostomies in these children which have obvious inconvenient and potentially lethal complications.

[Testicular tumors in childhood. Review of cases in the course of 13 years]. / Tumores testiculares en la infancia. Revisión de 13 años.

Testicular and paratesticular tumors are rare in childhood, representing 1-2 percent of the solid tumors in the pediatric age. In patients under 14 years, the incidence is 0.5-2/100,000. The evolution differs from that of the adult. Since 1981 to 1994 we have treated 14 cases of testicular and paratesticular tumors. Mean age was 2.54 years, the younger patients presenting germinal tumors. The most frequent tumor was the yolk sac tumor (36%), followed by teratoma mature (29%), and Leydig cell tumor, epidermoid cyst, paratesticular fibrous hamartoma, paratesticular neuroblastoma and paratesticular rabdomyosarcoma (7% each). A testicular mass was present in all cases (100%). Testicular ultrasound was used in 100%. In all the patients with malignant tumors a thoraco-abdominal CT scans was done to rule out extension or the tumor, being negative in all cases. Alphafetoprotein were high in all the cases of yolk sac tumor, being within normal range one month after surgery except in one case. In 11 patients an orquiectomy was done through an inguinal approach, and in three cases a simple tumorectomy without orquiectomy. No lymphadenectomy was done. All the malignants neoplasms were stage I tumors, except one yolk sac tumor stage III. Postop chemotherapy was applied in this one and in the embrionary rabdomyosarcoma. There were no recurrences after a follow-up mean time of 3.98.