Clinical practice: Noninvasive respiratory support in newborns

The most important goal of introducing noninvasive ventilation (NIV) has been to decrease the need for intubation and, therefore, mechanical ventilation in newborns. As a result, this technique may reduce the incidence of bronchopulmonary dysplasia (BPD). In addition to nasal CPAP, improvements in sensors and flow delivery systems have resulted in the introduction of a variety of other types of NIV. For the optimal application of these novelties, a thorough physiological knowledge of mechanics of the respiratory system is necessary. In this overview, the modern insights of noninvasive respiratory therapy in newborns are discussed. These aspects include respiratory support in the delivery room; conventional and modern nCPAP; humidified, heated, and high-flow nasal cannula ventilation; and nasal intermittent positive pressure ventilation. Finally, an algorithm is presented describing common practice in taking care of respiratory distress in prematurely born infants

Small molecules, big targets: drug discovery faces the protein-protein interaction challenge.

Protein-protein interactions (PPIs) are of pivotal importance in the regulation of biological systems and are consequently implicated in the development of disease states. Recent work has begun to show that, with the right tools, certain classes of PPI can yield to the efforts of medicinal chemists to develop inhibitors, and the first PPI inhibitors have reached clinical development. In this Review, we describe the research leading to these breakthroughs and highlight the existence of groups of structurally related PPIs within the PPI target class. For each of these groups, we use examples of successful discovery efforts to illustrate the research strategies that have proved most useful.JS, DES and ARB thank the Wellcome Trust for funding.This is the author accepted manuscript. The final version is available from Nature Publishing Group via http://dx.doi.org/10.1038/nrd.2016.2

Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure.

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP

Antiseptics and Disinfectants

Antiseptics and disinfectants (see definitions) share common skin side effects, i.e., irritation, allergic contact dermatitis, and eventually immunological contact urticaria. Some antiseptics fall into disuse, due to their lack of efficacy (dyes) or their strong allergic properties (mercurials), except thiomersal, the indications of which remain important. Current antiseptics (i.e., povidone-iodine or chlorhexidine) are of great importance, due to the emergence of MRSA and CA-MRSA, leading to a decrease in the use of topical antibiotics to which Gram-positive and Gram-negative bacteria are more and more resistant. Silver-based wound and burn dressings may lead to new cases of allergic contact dermatitis, mainly related to the incorporation of new antiseptics, such as octenidine or PHMB. Disinfectants are a common source of occupational irritant and/or allergic contact dermatitis. Aldehydes are widely used as disinfectants. Formaldehyde, glutaraldehyde, and glyoxal are responsible for many cases of allergic contact dermatitis. Quaternary ammonium compounds, and particularly benzalkonium chloride, are disinfectants provoking irritant and/or allergic contact dermatitis. The interpretation of patch tests is difficult, and the use of ROATs is advised