Uso y duración de terapia antibiótica en la exacerbación pulmonar aguda de la fibrosis quística: un tema aún sin definir

Cystic fibrosis is a condition about which not much is yet known and remains a hot topic in translational and pulmonary medicine. Evidence on the management of exacerbations is limited, with few clinical trials and systematic reviews. For example, the use and duration of antibiotics in this condition is unknown. Considering that this is a disease that entails high health costs and substantially decreases the functional capacity of the affected person, it is necessary to quickly establish practical algorithms based on evidence. Based on the above, the objective of this narrative review is to synthesize evidence on the use and duration of antibiotic therapy in acute pulmonary exacerbations in patients with cystic fibrosis. For this, a bibliographic search was carried out in the search engines and databases PubMed, ScienceDirect, Embase, EBSCO and MEDLINE. It was defined that any article related to the evaluation of the use and duration of antibiotic therapy in acute pulmonary exacerbation in patients with cystic fibrosis would be included, giving priority to original studies and systematic reviews and meta-analyses. After the review of the title and the summary of all the results, 42 articles were finally included. It was found that antibiotic therapy 10 days after standard treatment, by intravenous route, either doxycycline or azithromycin plus colistimethate, allows greater recovery of lost pulmonary function, lengthens the time until the next exacerbation and resolves symptoms quickly.La fibrosis quística es una enfermedad sobre la que aún no se sabe mucho y sigue siendo un tema candente en la medicina traslacional y pulmonar. La evidencia sobre el manejo de las exacerbaciones es limitada, con pocos ensayos clínicos y revisiones sistemáticas. Por ejemplo, se desconoce el uso y la duración de los antibióticos en esta enfermedad. Teniendo en cuenta que se trata de una enfermedad que supone un elevado coste sanitario y que disminuye sustancialmente la capacidad funcional del afectado, es necesario establecer rápidamente algoritmos prácticos basados en la evidencia. En base a lo anterior, el objetivo de esta revisión narrativa es sintetizar evidencia sobre el uso y la duración del tratamiento antibiótico en las exacerbaciones pulmonares agudas en pacientes con fibrosis quística. Para esto, se llevó a cabo una búsqueda bibliográfica en los motores de búsqueda y bases de datos bases de datos PubMed, ScienceDirect, Embase, EBSCO y MEDLINE. Se definió que cualquier artículo relacionado con la evaluación del uso y duración de antibioticoterapia en la exacerbación aguda pulmonar del paciente con fibrosis quística, sería incluido, dando prioridad a los estudios originales y a las revisiones sistemáticas y meta-análisis. Posterior a la revisión del título y resumen de todos los resultados, se incluyeron 42 artículos. Se encontró que instaurar antibioticoterapia 10 días posterior al tratamiento estándar, por vía intravenosa, ya sea de doxiciclina o azitromicina más colistimetato, permite obtener mayor recuperación de la función pulmonar perdida, alargar el tiempo hasta la próxima exacerbación y solucionar sintomatología rápidamente

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe