Automated low-cost device to produce sub-micrometric polymer fibers based on blow spun method.

Attending the latest advances in polymeric fibers, the design of low-cost, and high-quality scientific equipment for obtaining fibers seemed essential. To overcome this challenge, a 3D printable prototype was designed, assembled, and validated to obtain fibers using the SBS method. The particular configuration of the prototype consisted of controlling the process conditions such as working distance and injection flow, as well as other parameters such as RPM and the axial movement of the cylindrical collector. Thus, these parameters were automated using a microcontroller (Arduino) that receives information from an Android device with bluetooth connectivity to control each of the elements of the equipment. Subsequently, the repeatability and reproducibility of the fibers was verified using polymers such as polystyrene (PS), polysulfone (PSF) and polyethylene oxide (PEO); furthermore, PSF fibers were manufactured to analyze the influence of working distance and the axial movement of the collector on their production.

SEAIC Specialty Forum: Analysis of the Current Situation of Allergology in Spain and Outlook for the Future.

BACKGROUND AND OBJECTIVES: Allergology has been a recognized medical specialty in Spain, with fully defined aims and competencies for more than 4 decades. However, in recent years, its visibility seems to have decreased somewhat. Objectives: To identify which specific factors have contributed to the waning of the importance of the specialty and find tangible solutions to consolidate its place as a front-line medical specialty. MATERIAL AND METHODS: An online population survey comprising 60 items of interest was prepared. The degree of agreement and the level of satisfaction with each item were assessed, and implementable initiatives in the short, medium, and long terms were defined in order to provide solutions to the issues identified. RESULTS: The survey was completed by a total of 167 specialists with an average of 18 years' experience. Most were from public reference hospitals, and 29.3% were heads of department. The line of action for which a good degree of agreement was achieved was to promote the inclusion of an allergist in multidisciplinary teams. The priority lines of action were to improve undergraduate and graduate training in allergology and specialized nursing, to identify curricula in Spain, and to develop robust teaching projects. CONCLUSIONS: The results revealed a high degree of homogeneity between professionals. The basic pillars highlighted were as follows: quality training, knowledge, and research in immunotherapy; an innovative portfolio of services endorsed by clinical practice guidelines; and presence in multidisciplinary teams and relevant hospital committees.

SEAIC Specialty Forum: Analysis of the Current Situation of Allergology in Spain and Outlook for the Future

Background: Allergology has been a recognized medical specialty in Spain, with fully defined aims and competencies for more than 4 decades. However, in recent years, its visibility seems to have decreased somewhat. Objectives: To identify which specific factors have contributed to the waning of the importance of the specialty and find tangible solutions to consolidate its place as a front-line medical specialty. Material and methods: An online population survey comprising 60 items of interest was prepared. The degree of agreement and the level of satisfaction with each item were assessed, and implementable initiatives in the short, medium, and long terms were defined in order to provide solutions to the issues identified. Results: The survey was completed by a total of 167 specialists with an average of 18 years’ experience. Most were from public reference hospitals, and 29.3% were heads of department. The line of action for which a good degree of agreement was achieved was to promote the inclusion of an allergist in multidisciplinary teams. The priority lines of action were to improve undergraduate and graduate training in allergology and specialized nursing, to identify curricula in Spain, and to develop robust teaching projects. Conclusions: The results revealed a high degree of homogeneity between professionals. The basic pillars highlighted were as follows: quality training, knowledge, and research in immunotherapy; an innovative portfolio of services endorsed by clinical practice guidelines; and presence in multidisciplinary teams and relevant hospital committees. (AU)

Antecedentes: En nuestro país, la alergología constituye una especialidad médica reconocida con fines y competencias completamente definidos desde hace más de cuatro décadas. Sin embargo, en los últimos tiempos parece hacer frente a una cierta disminución de su visibilidad y reconocimiento. Objetivos: Identificar qué factores específicos contribuyen a esta dilución de su peso específico y buscar soluciones tangibles que la afiancen como especialidad médica de primera línea. Material y métodos: Se elaboró una encuesta poblacional online compuesta por 60 ítems considerados de interés. Se valoró el grado de acuerdo y el nivel de satisfacción con cada uno, definiendo iniciativas implantables a corto, medio y largo plazo que aporten soluciones para las cuestiones identificadas. Resultados: La encuesta fue respondida por un total de 167 especialistas con una media de 18 años de experiencia, la mayoría procedentes de hospitales de referencia públicos, siendo un 29,3% jefes del servicio. La línea de acción que obtuvo un mayor grado de acuerdo fue promover la presencia del alergólogo en los equipos multidisciplinares. Como línea de acción más prioritaria se seleccionó mejorar la formación de pregrado y posgrado en alergología, así como la de enfermería especializada, identificando planes de estudio en nuestro país y elaborando proyectos docentes robustos. Conclusiones: Los resultados revelaron un elevado grado de homogeneidad entre los profesionales, destacando como pilares básicos la formación de calidad, los conocimientos e investigación en inmunoterapia, una cartera de servicios novedosa avalada por Guías de Práctica Clínica y la presencia en equipos multidisciplinares y comisiones hospitalarias relevantes. (AU)

Cutoff point for exhaled nitric oxide corresponding to 3% sputum eosinophils.

BACKGROUND: The eosinophilic asthma phenotype (sputum eosinophils 3%) indicates a good response to corticosteroids and T(H)2 immunomodulators. Exhaled nitric oxide (FeNO) is rapidly measured by portable devices, and although it is not a selective marker of eosinophilic inflammation, several studies have demonstrated a strong correlation with it. We investigated which FeNO value was the best fit with 3% sputum eosinophils in asthma patients. METHODS: We included 129 consecutive, nonsmoking asthmatics who underwent skin tests, FeNO quantification (NIOX MINO), spirometry, and induced sputum analysis and completed the Asthma Control Test questionnaire. Receiver operating characteristic curves were constructed, and logistic regression analysis was performed. RESULTS: Symptoms were detected more frequently in the eosinophilic asthma group, as were higher airway obstruction and sensitivity to hypertonic saline. The FeNO cutoff point of 21 ppb was the best fit with 3% sputum eosinophilia. This value behaved better among corticosteroid-naïve patients (sensitivity, 97%; specificity, 58%; positive predictive value, 86%; negative predictive value, 88%) than among those receiving corticosteroids (sensitivity, 81%; specificity, 25%; positive predictive value, 74%; negative predictive value, 33%). CONCLUSION: FeNO ≥ 21 ppb is associated with airway eosinophilia. In corticosteroid-naïve patients, FeNO < 21 ppb enables us to rule out airway eosinophilia.

Multiuser CSK scheme for indoor visible light communications.

Color Shift Keying (CSK) is a new modulation scheme for visible light communication systems using RGB LEDs which has been standardized in the PHY III level of the IEEE 802.15.7. This paper proposes some modifications so as to include multiuser capabilities provided by a time-based multiplexing, with the modulation constellation symbols being adapted to encode data with the luminux powers of the red, green and blue color bands respectively. This is achieved by employing a simple and low-complexity time-based pulse signals structure to separate the users' data symbols, while a three-dimensional signal constellation design is merged to improve data throughput. Numerical simulations are carried out to assess the performance of this novel architecture. The statistical properties of the transmitted RGB signals ensure dimming capabilities and that the illumination function is unaffected by flickering.

Spirometric and exhaled nitric oxide reference values in preschool children from the community of Navarra.

BACKGROUND AND OBJECTIVE: Preschool children can perform quality, reproducible spirometric maneuvers, provided appropriate equipment is used and specially trained nursing staff training are available. However, use of spirometry for the diagnosis and follow-up of preschool children with respiratory diseases remains limited in clinical practice, because consensus on test quality and acceptability criteria and reference data are lacking. We initiated the present study with the aim of developing reference equations, since tables of normal values for this age group are not available in our area. PATIENTS AND METHODS: The study population comprised healthy preschool children in our community. Normal values for exhaled nitric oxide in this age range were assessed. Regression equations were constructed using univariate and multivariate models. RESULTS: A total of 114 healthy preschool children aged 3 to 6 years were enrolled. According to the criteria of the American Thoracic Society/European Respiratory Society, 60 children were able to perform acceptable and reproducible spirometric maneuvers. The best correlations were observed for the untransformed linear regression model that included height. The correlation coefficients for forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV0.5 were 0.89, 0.88, and 0.86, respectively. The regression equations for the calculation of reference values were as follows: FVC = -2.6 + 0.036 x height, cm FEV1 = -2.04 + 0.029 x height, cm FEV0.5 = -1.53 + 0.022 x height, cm. We obtained fraction of inhaled nitric oxygen (FeNO) values for 56 children. The mean (SD) value was 11 (4.9) ppb. CONCLUSIONS: Most preschool children in our area were able to perform quality spirometry maneuvers. We obtained regression equations that allowed us to calculate the reference ranges in our population and the distribution of normal FeNO values.

[Spirometry quality in preschool children]. / Calidad de la espirometría en preescolares.

BACKGROUND: Carrying out quality spirometric maneuvers in preschool children in both the diagnosis and follow-up of respiratory diseases continues to be very scarce. This is due to several reasons, including a lack of consensus on quality criteria and the acceptability of the test. The purpose of this study is therefore to obtain reference norms from a population of healthy preschool children from the Autonomous Community of Navarre (Spain). METHOD: A total of 114 healthy preschool children aged between 3 and 7 years of age, without prior experience in carrying out lung function tests, were included. RESULTS: A total of 76 were able to realize at least two acceptable spirometric maneuvers, and 60 of them maneuvers that were acceptable and reproducible, according to ATS/ERS criteria. This represents a global success percentage of 59%. The most common failing was premature and brusque termination of the spirometric maneuver, followed by an inadequate peak in breathing. CONCLUSIONS: Over half of the preschool children were able to realize quality spirometric maneuvers. Our data make it possible to recommend the proposed quality criteria as being suitable for routine use, and to encourage the use of spirometry in regular clinical practice within the setting of specialized care.

Anal carcinoma and HIV infection: is it time for screening?

A 38-year-old white man had a 10-year history of human immunodeficiency virus (HIV) infection (A3), with no episodes of opportunistic diseases and in good immunologic recovery (CD4 cell count: 450 and indetectable HIV viral load) while on HAART. He presented with a two-month history of mild anal symptoms, including pruritus and episodic bleeding. He referred past episodes of anal warts, self-treated with several topical compounds, all proven unsuccessful. Perianal examination showed erythema and scratching. A 0.5cm sized tumor, with infiltration at the base was detected on digital exam, located at 15mm from the anal margin. Local biopsy driven by high-resolution anuscopy (AAR) yielded a final diagnosis of infiltrative epidermoid carcinoma. Might that neoplasia have been prevented?

Characterization of the autonomic system during the cyclic alternating pattern of sleep.

Evaluation of the RR variability was carried out during the Cyclic Alternating Pattern (CAP) in sleep. CAP is a central phenomenon formed by short events called A-phases that break basal electroencephalogram (EEG) oscillations of the sleep stages. A-phases are classified in three types (A1, A2 and A3) based on the EEG desynchronization during A-phase. However, the relation of A-phases with other systems, such as cardiovascular system, is unclear and a deep analysis is required. For the study, six patients with Nocturnal Front Lobe Epilepsy (NFLE) and other six healthy controls patients underwent whole night polysomnographic recordings with CAP and hypnogram annotations. Amplitude reduction and time delay of the RR intervals minimum with respect to A-phases onset were computed. In addition, the same process was computed over randomly chosen RR interval segments during the NREM sleep for further comparison. The results suggest that the onset of the A-phases is correlated with a significative increase of the heart rate that peaks at around 4s after the Aphase onset, independently of the A-phase subtype.

Isolation of Legionella species/serogroups from water cooling systems compared with potable water systems in Spanish healthcare facilities.

Surveillance of Legionella spp. in hospital water systems was performed in forty-four inpatient healthcare facilities in Spain during 2005-2006. A total of 2,341 samples were collected: 470 from cooling systems (cooling towers) and 1,871 from potable water systems. The latter included 211 from cold-water tanks and 260 from hot-water tanks, totalling 471 from central water reservoirs 136 from showers, 1,172 from unfiltered taps and 92 from filtered taps, totalling 1,400 from peripheral points. Temperature, chlorine levels and the presence of Legionella spp. were determined. In all, 373 (15.9%) samples yielded Legionella spp. Significantly higher isolation rates were obtained from cooling towers (23.8%) versus cold- and hot-water tanks (approximately 4.7%), due to the significantly higher number of samples positive for serogroup 1 (19.4 vs 0.9-3.5%). In potable water systems, no differences were found between central water tanks and showers, but significant differences in isolation rates between central water tanks and unfiltered taps were observed (4.7 vs 19.6%) due to differences in non-serogroup 1 L. pneumophila. Filters significantly decreased isolation rates of these serotypes (11 vs 0%). Some seasonal differences were noted, with higher isolation rates in summer for legionella serogroup 1 in cooling systems and for L. pneumophila serogroups 2-14 in potable water systems. In regression models, higher temperatures were associated with colonisation in cooling systems, while lower chlorine levels were associated with colonisation in potable water systems.

Duration of asthma and lung function in life-long nonsmoking adults.

BACKGROUND: The airways of adult or elderly asthmatics are likely candidates for airway remodeling, resulting in persistent airflow obstruction. This population can provide a good model for cross-sectional evaluation of the effect of asthma duration on airflow. METHODS: We evaluated postbronchodilator airflow and lung volumes at baseline and after a short course of oral prednisone in a group of 42 never-smokers with persistent mild or moderate asthma aged 55 years or older. Patients were grouped as having short duration asthma (SDA, <14 years) or long duration asthma (LDA, > or =14 years) according to the median duration of the disease (14 years) of the sample. RESULTS: There were no significant differences in patient characteristics or asthma severity indices between the groups. After a short course of prednisone, forced expiratory volume in 1 second (FEV1) and the ratio of FEV to forced vital capacity (FVC) were significantly higher for the SDA group. Only 3 patients presented persistent airflow limitation (FEV1/FVC% < 75%). An inverse correlation was demonstrated between duration of asthma and postbronchodilator FEV1 (% predicted) (r = -0.43, P = .01) and FEV1/FVC% (r = -0.50, P = .003). CONCLUSION: Our data show a close relationship between duration of disease and loss of lung function, supporting the concept of asthma as a slow, progressive disease at least among those patients with a mild-to-moderate severity. Permanent airflow obstruction in mild or moderate asthma is unusual, but can occur in a small number suffering from the disease for years.

Discriminant analysis in allergic rhinitis and asthma: methacholine dose-response slope allows a good differentiation between mild asthma and rhinitis.

Asthma and rhinitis frequently coexist in allergic patients, but nasal symptoms may predominate, leading to asthma underdiagnosis and undertreatment. Discriminant analysis obtains the best differentiation between groups using one or one set of variables. Our aim was to identify the laboratory test [allergen exposure, total and specific serum IgE, lung function, blood eosinophils and, bronchial response and sensitivity to methacholine (Mth) and allergen] or combination of them that allowed the best differentiation between mild asthma and allergic rhinitis. A cross-sectional analysis was performed in 86 Dermatophogoides pteronyssinus allergic rhinitis patients, who were classified according to clinical data as rhinitis plus mild asthma (n = 62) or "pure" rhinitis (n = 24). Bronchial symptoms had been exhaustively evaluated during a 2-years pre-inclusion period. Patients underwent skin tests and bronchial challenge with Mth and allergen. The exposure to D. pteronyssinus allergen (Der pl) was quantified in dust samples. Dose-response curves with Mth [until the FEV1 fell by 40% or the maximal dose (200 mg/ml) was inhaled] were attained. We developed multiple models of discriminant analysis in order to evaluate the capacity of the above variables to differentiate groups. Asthma patients had higher total and specific IgE levels and a greater sensitivity (PD20 values) and response [dose-response slope (DRS)] to both Mth and allergen. The model entering these variables was the one that correctly classified more patients (79.2%). The discriminative power of the model that only included Mth-DRS values was similar to the above (78.8%). Bronchial response to Mth is quantitatively different in allergic rhinitis patients who display mild asthma symptoms when compared to those that only report rhinitis, suggesting a distinct bronchial intrinsic behavior. The utilization of complete dose-response curves with Mth allows a good separation between mild asthma and "pure" rhinitis patients and might be useful in the diagnosis of mild asthma. Whether the early detection and treatment of these patients prevents the development of symptomatic asthma needs further evaluation.

Antigenicity of a recombinant NS3 protein representative of ATPase/helicase domain from hepatitis C virus.

It has been shown that the Hepatitis C virus nonstructural NS3 protein possesses at least two enzymatic domains: a serine-protease domain and an adenosine triphosphatase (ATPase)/helicase domain. In this report, a truncated fragment of NS3 (26 kDa), representing main epitopes from the (ATPase)/helicase domain, has been expressed in Escherichia coli. The recombinant protein was purified by Ion Metal Affinity Chromatography (IMAC) with more than 90% purity. The recognition of B-cell linear epitopes in the NS3 protein was evaluated by immunoblot. The recombinant NS3 protein was reduced and carboxymethylated, and the recognition of either conformational and/or linear B-cell determinants was evaluated by ELISA. The inclusion of the recombinant NS3 protein in a third-generation diagnostic system UltraMicroELISA (UMELISA) allowed an increase in the sensitivity, due to the detection of a new variety of false-negative sera in blood donor test samples.

Mortality due to liver failure and impact on survival of hepatitis virus infections in HIV-infected patients receiving potent antiretroviral therapy.

The aim of the present study was to examine the causes of death, the mortality attributable to liver failure, and the impact of hepatitis virus infections on the survival of a cohort of HIV-infected patients before and after the extensive use of highly active antiretroviral therapy (HAART). Liver disease associated with hepatitis C virus (HCV) seems to be accelerated in patients infected with the human immunodeficiency virus (HIV). On the other hand, the effect of HCV on HIV progression was controversial before the introduction of HAART. However, the last study to report changes in mortality due to liver failure was published in 1997, and the impact of HCV carriage on the survival of HIV-infected patients receiving HAART needs to be clarified. In this investigation, 492 patients who were prescribed antiretroviral drugs between April 1989 and September 2000 were included in the study cohort. The median duration of follow-up of the cohort was 1,392 days. HCV infection was present in 323 (68%). Mortality attributable to AIDS decreased from 4.5 to 1.8 per 100 persons per year. Mortality due to liver failure increased from 0.3 to 0.5 per 100 persons per year ( P<0.01). The survival of patients with and without HCV infection was similar ( P=0.8). Although liver failure is an increasing cause of death among HIV-infected patients receiving HAART, HCV infection has still no impact on the survival of HIV-infected patients.

[Prognostic factors of mortality during the episode of pneumonia due to Pneumocystis carinii in patients with HIV infection]. / Factores pronósticos de mortalidad durante el episodio de neumonía por Pneumocystis carinii en pacientes con infección por VIH.

BACKGROUND: Despite a steady decrease in its incidence, pneumonia caused by Pneumocystis carinii (PCP) are still diagnosed, and they occur frequently in patients unaware of being infected with the human immunodeficiency virus (HIV). Since it is a disease with a high mortality risk, its early diagnosis and therapy would allow these patients to benefit from the advantages afforded Pneumocystis carinii, neumonía, infecciones oportunistas relacionadas con el sida, pronóstico.by anti-retroviral therapy. PATIENTS AND METHODS: Retrospective study, in which all adult HIV infected patients with microbiologically demonstrated PCP diagnosed at two tertiary-level hospitals in our country between 1985 and 1996 were included. The clinical records of patients were used as information source. The relative risks (RR) of death were estimated by the multivariant logistic regression. RESULTS: PCP was the first AIDS indicating disease in approximately 70 % of cases. Thirteen percent of patients died during the episode. Patients aged over 45 years had a death RR during the episode of 3.15 (95 % CI from 0.8 to 12.2); patients previously diagnosed of AIDS had a death RR of 3.4 (95 % CI from 1.3 to 9), and those with an alveolar-arterial oxygen gradient (pA-aO2) > 50 mmHg, a death RR of 3 (95% CI from 1.1 to 8). CONCLUSIONS: Factors independently related to survival to the PCP episode are age below 45 years, not to have had another AIDS indicating disease, and to have a pA-aO2 below 50 mmHg at diagnosis.

Clinicopathological factors in early squamous cell carcinoma of the tongue and floor of the mouth, in Biscay (the Basque Country, Spain).

OBJECTIVES: A study is made of the main clinicopathological factors in squamous cell carcinoma (SCC) of the tongue and floor of the mouth in the province of Vizcaya (Biscay) (The Basque Country, Spain), and their relation to patient prognosis. DESIGN: A retrospective study was made of 40 patients with early (clinical stage I/II) SCC of the tongue and floor of the mouth. A previously designed protocol was used to record the clinical and histopathological data, which were subjected to descriptive and comparative bi- and multivariate statistical and survival analyses. RESULTS: There were 34 males and 6 females, with a mean age of 55.7 years (range 33-81). In 23 cases the SCC was located in the tongue, and in 17 cases in the floor of the mouth. The average tumor diameter was 2.6 cm; 65% of the neoplasms were ulcerated. The mean clinical course was 3.4 months, with an average tumor growth rate or velocity of 268 (Evans formula). Thirty-four patients were smokers and 33 consumed alcohol. All SCC of the floor of the mouth, and all regional recurrences, were diagnosed in smokers and drinkers. Survival at 5 years was 65%. Well differentiated SCC were diagnosed in 52.5% of cases. The average histological malignancy grade was 1.96, and was higher in males, tongue malignancies, T2 lesions, tumors with growth velocities above 200, and in recurrent neoplasms. CONCLUSIONS: Early SCC of the tongue and floor of the mouth in Vizcaya affects mainly male smokers and drinkers of alcohol under the age of 60 years. A relationship is observed between the histopathological findings (particularly invasion mode and stage) and patient prognosis.

Chiral softballs: synthesis and molecular recognition properties.

Studies on the different congeners of the softball were undertaken to explore structural variants for enantioselective encapsulation. Two different spacer elements in the monomeric subunit render the dimeric softball chiral although the monomer itself is achiral. The dimers represent capsules with dissymmetric cavities with volumes ranging from 190 to 390 A(3). The cavities are distorted spheres, and asymmetric guests, such as naturally occurring terpenes, generally prefer one enantiomer of the capsule to its mirror image. The selectivities are moderate (up to 4:1). The complexation studies show that the host capsules are flexible enough to arrange themselves comfortably around a guest but still maintain enough rigidity to be influenced by the occupancy of a chiral guest. The enantiomeric capsules can interconvert (racemize) by dissociation and recombination of their subunits.