Imágenes multimodales en desgarro del epitelio pigmentario de la retina. Reporte de caso / Multimodal imaging in retinal pigment epithelium tear. Case report

Los desgarros del epitelio pigmentario de la retina (EPR) pueden ocurrir espontáneamente o asociados al tratamiento con terapia antiangiogénica intravítrea (anti-VEGF) para la degeneración macular asociada a la edad neovascular (DMAEn). El objetivo de este estudio fue describir el caso de un desgarro del EPR en un paciente con neovascularización macular luego del tratamiento con terapia anti-VEGF. Paciente de sexo masculino, de 73 años, con diagnóstico de neovascularización macular mixta y desprendimiento fibrovascular del EPR en el ojo derecho; recibió tratamiento con terapia antiangiogénica, presentando un desgarro del EPR. Este puede desarrollarse como una complicación asociada al tratamiento con terapia anti-VEGF en pacientes con DMAEn. Describimos el uso de imágenes multimodales en el diagnóstico de esta patología.

Retinal pigment epithelium (RPE) tears can occur spontaneously or in association with intravitreal antiangiogenic therapy (anti-VEGF) treatment for neovascular age-related macular degeneration (AMD). The objective of this study was to describe the case of a RPE tear in a patient with macular neovascularization after treatment with anti-VEGF therapy. A 73-year-old male patient with a diagnosis of mixed macular neovascularization and fibrovascular detachment of the RPE in the right eye; he received treatment with antiangiogenic therapy, presenting a RPE tear. This can develop as a complication associated with treatment with anti-VEGF therapy in patients with AMD. We describe the use of multimodal imaging in the diagnosis of this pathology.

Tumor esternal autolimitado de la infancia (SELSTOC) con hallazgos atípicos en ecografía y manejo conservador / Self-limiting sternal tumours of childhood (SELSTOC) with atypical ultrasound features and conservative

Los SELSTOC (del inglés, self-limiting sternal tumors of childhood) son lesiones benignas de rápido crecimiento, palpables y no dolorosas, que afectan a pacientes en edad pediátrica y tienen un curso autolimitado. Aunque su etiología es desconocida, se ha descrito que está relacionada con una reacción inflamatoria aséptica. La mayoría de los casos publicados presentan un patrón típico en ecografía, que consiste en una masa de partes blandas no vascularizada con forma de reloj de arena, situada anterior y posterior al esternón. A diferencia de los anteriores, el caso que describimos en un paciente de 9 meses presentó una morfología irregular atípica en ecografía, así como una afectación limitada al tejido subcutáneo paraesternal derecho, sin extensión en profundidad a la zona retroesternal ni intercostal. Se decidió una actitud expectante y seguimiento con ecografía mensual, mediante el cual se demostró la resolución completa de la lesión a los 3 meses. Por tanto, resulta crucial conocer la historia natural de los SELSTOC y sus apariencias radiológicas típicas y atípicas, para no causar alarma, optar por un manejo conservador y evitar los posibles daños iatrogénicos derivados de actuaciones médicas agresivas (biopsia percutánea o extirpación quirúrgica). Asimismo, un enfoque diagnóstico adecuado, incluso cuando existen hallazgos ecográficos poco frecuentes, permite prescindir de pruebas de imagen con altas dosis de radiación ionizante (tomografía computarizada) y de derivaciones innecesarias a centros hospitalarios de mayor complejidad (AU)

“SELSTOC” (Self-Limiting Sternal Tumours of Childhood) are fast growing benign lesions, palpable and not painful, that affect patients in paediatric age. Although its aetiology is unknown, it has been reported to be related to an aseptic inflammatory reaction. Most of the cases already published show a typical pattern in echography, that consists of a non-vascularized dumbbell-shaped growing lump in soft tissues which does not affect bone structures, located in the anterior and posterior part of the sternum. Unlike most cases, the case we are describing in a 9-months-old patient presents an irregular morphology that is atypical in echography, as well as limited affectation of the right subcutaneous parasternal tissue, without a depth extension of the retrosternal or intercostal areas. Wait-and-see approach was decided as well as monthly echography monitoring, whereby it was evidenced the complete resolution of the lesion within three months.So, it is crucial to know the natural history of SELSTOC, and its typical and atypical radiological appearance, so as not to cause alarm, to choose a conservative approach and to avoid possible iatrogenic harm derived from aggressive medical actions (percutaneous biopsy or surgical removal). So, an adequate diagnostic approach, even when there are infrequent ultrasound findings, can avoid high dose ionizing radiation tests (Computed Tomography) and unnecessary referrals to more specialised hospitals. (AU)

Colorimetric and fluorescent detection of synthetic cathinones in oral fluid with meso-aryl BODIPYs and Cu(ii).

Synthetic cathinones are a class of new psychoactive substances whose consumption has increased a lot and is widespread throughout the world. Thus, there is currently a need for rapid and simple detection of these drugs. In particular, detection of synthetic cathinones in oral fluid in drivers can be of great importance in preventing traffic accidents. Herein, we report two probes, based on BODIPY derivatives combined with Cu(ii), which are able to detect these drugs both in water and in oral fluid, by changes in color and fluorescence. The determined limits of detection for ephedrone (as a model drug) are lower than the usual concentrations in saliva after intake of this type of drug. The sensing mechanism seems to be related to the cathinone induced reduction of Cu(ii) to Cu(i) with concomitants changes in the BODIPY structure.

Correction: Protection against chemical submission: naked-eye detection of γ-hydroxybutyric acid (GHB) in soft drinks and alcoholic beverages.

Correction for 'Protection against chemical submission: naked-eye detection of γ-hydroxybutyric acid (GHB) in soft drinks and alcoholic beverages' by Silvia Rodríguez-Nuévalos et al., Chem. Commun., 2020, 56, 12600-12603, https://doi.org/10.1039/D0CC05387B.

Heteroditopic chemosensor to detect γ-hydroxybutyric acid (GHB) in soft drinks and alcoholic beverages.

Drug-Facilitated Sexual Assault (DFSA) is a problem of considerable dimensions on a global scale. Among the different compounds used in DFSA assaults, 4-hydroxybutyric acid (GHB) is one of the most elusive due to its physical and biological characteristics. Therefore, the development of real-time detection methods to detect GHB not only in drinks but also in urine is very important for personal and social security. Here, we report two new heteroditopic chemosensors capable of recognizing and detecting GHB in soft drinks, alcoholic beverages and synthetic urine. The compounds have two moieties: a trifluoroacetyl group and a thiourea, which are able to interact respectively with the hydroxyl and the carboxylic groups present in the GHB structure. In addition, the distance between these two groups has been optimized to allow a double interaction which guarantees the recognition even in very competitive media such as beverages or urine samples.

Chromogenic Chemodosimeter Based on Capped Silica Particles to Detect Spermine and Spermidine.

A new hybrid organic-inorganic material for sensing spermine (Spm) and spermidine (Spd) has been prepared and characterized. The material is based on MCM-41 particles functionalized with an N-hydroxysuccinimide derivative and loaded with Rhodamine 6G. The cargo is kept inside the porous material due to the formation of a double layer of organic matter. The inner layer is covalently bound to the silica particles, while the external layer is formed through hydrogen and hydrophobic interactions. The limits of detection determined by fluorimetric titration are 27 µM and 45 µM for Spm and Spd, respectively. The sensor remains silent in the presence of other biologically important amines and is able to detect Spm and Spd in both aqueous solution and cells.

Mesoporous Silica Nanoparticles in Chemical Detection: From Small Species to Large Bio-Molecules.

A recompilation of applications of mesoporous silica nanoparticles in sensing from the last five years is presented. Its high potential, especially as hybrid materials combined with organic or bio-molecules, is shown. Adding to the multiplying effect of loading high amounts of the transducer into the pores, the selectivity attained by the interaction of the analyte with the layer decorating the material is described. Examples of the different methodologies are presented.

Protection against chemical submission: naked-eye detection of γ-hydroxybutyric acid (GHB) in soft drinks and alcoholic beverages.

Two new oxazole derivatives, able to detect γ-hydroxybutyric acid (GHB) in soft drinks and alcoholic beverages, by color and fluorescence changes, are reported.

Fellow eye comparison between alcohol-assisted and single-step transepithelial photorefractive keratectomy: late mid-term outcomes.

Objective: To compare late mid-term results of two different surgical approaches of surface excimer laser ablation for myopic and astigmatic errors in contralateral eyes of the same patients. Methods: Prospective cohort study. A photorefractive keratectomy technique was performed on the right eye and single-step transepithelial photorefractive keratectomy on the left eye of the same patient, in 2012. Postoperative uncorrected and corrected visual acuities, manifest refraction, contrast sensitivity, objective scatter index, tear film stability assessed by serial measurements of objective scatter index and aberrometry as well as occurrence of haze, were compared between groups of eyes. Results: Thirty-two eyes of 16 patients with a mean time of follow-up of 35.2 +/ - 5.0 months (range 30-46 months) were evaluated. No significant differences were observed in postoperative results (visual acuity, spherical equivalent, defocus equivalent, higher-order aberrations, objective scatter index, tear film stability and contrast sensitivity). Contrast sensitivity tended to be better in transepithelial photorefractive keratectomy technique, under photopic lighting conditions without glare and mesopic conditions both with glare and without glare, however, no statistically significant differences were found. No eye presented corneal haze at the last examination. Conclusion: No statistically significant differences in visual acuity, refractive results, contrast sensitivity, objective scatter index, tear film stability or ocular aberrometry were observed between the two surface ablation techniques.

Nanosensor for Sensitive Detection of the New Psychedelic Drug 25I-NBOMe.

This work reports the synthesis, characterization, and sensing behavior of a hybrid nanodevice for the detection of the potent abuse drug 25I-NBOMe. The system is based on mesoporous silica nanoparticles, loaded with a fluorescent dye, functionalized with a serotonin derivative and capped with the 5-HT2A receptor antibody. In the presence of 25I-NBOMe the capping antibody is displaced, leading to pore opening and rhodamine B release. This delivery was ascribed to 5-HT2A receptor antibody detachment from the surface due to its stronger coordination with 25I-NBOMe present in the solution. The prepared nanodevice allowed the sensitive (limit of detection of 0.6 µm) and selective recognition of the 25I-NBOMe drug (cocaine, heroin, mescaline, lysergic acid diethylamide, MDMA, and morphine were unable to induce pore opening and rhodamine B release). This nanodevice acts as a highly sensitive and selective fluorometric probe for the 25I-NBOMe illicit drug in artificial saliva and in sweets.

Not always what closes best opens better: mesoporous nanoparticles capped with organic gates.

Four types of calcined MCM-41 silica nanoparticles, loaded with dyes and capped with different gating ensembles are prepared and characterized. N1 and N2 nanoparticles are loaded with rhodamine 6G and capped with bulky poly(ethylene glycol) derivatives bearing ester groups (1 and 2). N3-N4 nanoparticles are loaded with sulforhodamine B and capped with self-immolative derivatives bearing ester moieties. In the absence of esterase enzyme negligible cargo release from N1, N3 and N4 nanoparticles is observed whereas a remarkable release for N2 is obtained most likely due to the formation of an irregular coating on the outer surface of the nanoparticles. In contrast, a marked delivery is found in N1, N3, and N4 in the presence of esterase enzyme. The delivery rate is related to the hydrophilic/hydrophobic character of the coating shell. The use of hydrophilic poly(ethylene glycol) derivatives as gating ensembles on N1 and N2 enables an easy access of esterase to the ester moieties with subsequent fast cargo release. On the other hand, the presence of a hydrophobic monolayer on N3 and N4 partially hinders esterase enzyme access to the ester groups and the rate of cargo release was decreased.

Efficacy of budesonide-loaded mesoporous silica microparticles capped with a bulky azo derivative in rats with TNBS-induced colitis.

A colon targeted drug delivery system for inflammatory bowel diseases (IBD), consisting in budesonide loaded mesoporous silica microparticles functionalized with a selective azo-molecular gate (M-Bud), has been evaluated for in vivo efficacy. Experimental colitis in male Wistar rats was induced by rectal instillation of 2,4,6-trinitrobenzenesulfonic acid (TNBS). M-Bud was orally administered to the rats as a suspension in water. Colon/body weight ratio, clinical activity score, and histological evaluation were used as inflammatory indices to measure the performance of the microparticles. The formulation was compared with a suspension prepared from the commercial drug Entocord®. Statistical analyses of all scores indicate that the controlled release of budesonide in colon from M-Bud showed efficacy similar to that of Entocord in the healing of induced colitis in rats.

Mesoporous silica microparticles gated with a bulky azo derivative for the controlled release of dyes/drugs in colon.

Mesoporous silica microparticles were prepared, loaded with the dye safranin O (M-Saf) or with the drug budesonide (M-Bud) and capped by the grafting of a bulky azo derivative. Cargo release from M-Saf at different pH values (mimicking those found in the gastrointestinal tract) in the absence or presence of sodium dithionite (a reducing agent mimicking azoreductase enzyme present in the colon) was tested. Negligible safranin O release was observed at pH 6.8 and 4.5, whereas a moderate delivery at pH 1.2 was noted and attributed to the hydrolysis of the urea bond that linked the azo derivative onto the external surface of the inorganic scaffold. Moreover, a marked release was observed when sodium dithionite was present and was ascribed to the rupture of the azo bond in the molecular gate. Budesonide release from M-Bud in the presence of sodium dithionite was also assessed by ultraviolet-visible spectroscopy and high performance liquid chromatography measurements. In addition, preliminary in vivo experiments with M-Saf carried out in mice indicated that the chemical integrity of the microparticles remained unaltered in the stomach and the small intestine, and safranin O seemed to be released in the colon.

Towards the fluorogenic detection of peroxide explosives through host-guest chemistry.

Two dansyl-modified ß-cyclodextrin derivatives (1 and 2) have been synthesized as host-guest sensory systems for the direct fluorescent detection of the peroxide explosives diacetone diperoxide (DADP) and triacetone triperoxide (TATP) in aqueous media. The sensing is based on the displacement of the dansyl moiety from the cavity of the cyclodextrin by the peroxide guest resulting in a decrease of the intensity of the fluorescence of the dye. Both systems showed similar fluorescent responses and were more sensitive towards TATP than DADP.

Smart gated magnetic silica mesoporous particles for targeted colon drug delivery: New approaches for inflammatory bowel diseases treatment.

Magnetic mesoporous silica microparticles were loaded with safranin O (S1) and with hydrocortisone (S2) and the outer surface functionalized with a bulky azo derivative bearing urea moieties. Aqueous suspensions of both solids at pH 7.4 showed negligible payload release whereas a marked delivery was observed in the presence of sodium dithionite due to the rupture of the azo bonds. Besides, a moderate cargo release was observed at acidic pH due to the hydrolysis of the urea bonds that linked the azo derivative onto the external surface of the inorganic scaffolds. In vitro digestion models showed that S1 and S2 microparticles could be used for the controlled release of payload in the reducing colon environment (in which azoreductase enzymes are present). On the other hand, in vivo pharmacokinetic studies in rats showed that safranine O release from S1 microparticles was concentrated in colon. The performance of S2 microparticles for the treatment of colitis in rats (induced by oral administration of a 2,4,6-trinitrobenzenesulfonic acid solution) was tested. The controlled release of hydrocortisone from S2 in the colon of injured rats induced marked reduction in colon/body weight ratio and in clinical activity score. Also, histological studies showed a marked decrease in inflammation followed by intensive regeneration and almost normal mucosal structure of the individuals treated with S2. Besides, the use of a magnetic belt increased the therapeutic performances of S2 due to an enhanced retention time of the particles in the colon.

Functional Magnetic Mesoporous Silica Microparticles Capped with an Azo-Derivative: A Promising Colon Drug Delivery Device.

Magnetic micro-sized mesoporous silica particles were used for the preparation of a gated material able to release an entrapped cargo in the presence of an azo-reducing agent and, to some extent, at acidic pH. The magnetic mesoporous microparticles were loaded with safranin O and the external surface was functionalized with an azo derivative 1 (bearing a carbamate linkage) yielding solid S1. Aqueous suspensions of S1 at pH 7.4 showed negligible safranin O release due to the presence of the bulky azo derivative attached onto the external surface of the inorganic scaffold. However, in the presence of sodium dithionite (azoreductive agent), a remarkable safranin O delivery was observed. At acidic pH, a certain safranin O release from S1 was also found. The pH-triggered safranin O delivery was ascribed to the acid-induced hydrolysis of the carbamate moiety that linked the bulky azo derivatives onto the mesoporous inorganic magnetic support. The controlled release behavior of S1 was also tested using a model that simulated the gastro intestinal tract.

NO2-controlled cargo delivery from gated silica mesoporous nanoparticles.

Cargo delivery from mesoporous silica nanoparticles loaded with sulforhodamine B and capped with a difluoroboron-dipyrromethene (BODIPY) derivative was triggered by a NO2-induced oxidative process.

Understanding the experience of care managers and relationship with patient outcomes: the COMPASS initiative.

OBJECTIVE: To understand how care managers implemented COMPASS and if this was related to patient health outcomes. METHODS: A total of 96 COMPASS care managers were approached to participate in the online survey and 93 (97%) provided responses. Correlations were generated between key survey responses and the average number of care management contacts, patient depression, blood pressure and glycosylated hemoglobin outcomes. RESULTS: Patients of care managers who reported spending more time on COMPASS-related tasks had higher rates of depression improvement (r=0.34; P=.002) and remission (r=0.27; P=.02) as well as higher rates of blood pressure control (r=0.29; P=.03). CONCLUSIONS: To improve the effectiveness of care management in collaborative care models, particularly for patients with comorbid conditions and complex nonmedical needs, care managers need the support of social work and administrative support staff. Care managers for this patient population would also benefit from more intensive training in nonpharmacological depression treatment, such as motivational interviewing and behavioral activation. Additionally, systems support is needed such as education for primary care teams and psychiatry on the value of collaborative care models and integration of population management tools into electronic medical records.

Self-Immolative Linkers as Caps for the Design of Gated Silica Mesoporous Supports.

A new hybrid material based on sulforhodamine B dye-loaded silica mesoporous nanoparticles capped with a self-immolative gate has been synthesized and characterized. The gated material's controlled release behavior is monitored under different pH conditions. Under acidic and neutral conditions, a low level of dye release is detected. However, at slightly basic pH, significant dye release occurs owing to deprotonation of the phenol moiety in the capping molecule, which results in its disassembly.

3-Formyl-BODIPY Phenylhydrazone as a Chromo-Fluorogenic Probe for Selective Detection of NO2 (g).

A new colorimetric and fluorogenic probe, based on a 3-formyl boron dipyrromethene (BODIPY) phenylhydrazone, for the sensitive and selective detection NO2 (g) has been prepared. The probe in solution experiences a remarkable hypsochromic shift of its absorption and fluorescence emission bands in the presence gaseous NO2 (g), leading to limits of detection of few ppb. The probe also works in the solid phase, adsorbed on filter paper strips, or chemically immobilized on the surface of silica nanoparticles, with limits of detection to the naked eye of about 0.5 ppm.