Multisystem inflammatory syndrome in children in Western Countries? Decreasing Incidence as the pandemic progresses?: An observational multicenter international cross-sectional study

Background: SARS-CoV-2 variations as well as immune protection after previous infections and/or vaccination may have altered the incidence of multisystemic inflammatory syndrome in children (MIS-C). We aimed to report an international time-series analysis of the incidence of MIS-C to determine if there was a shift in the regions or countries included into the study. Methods: This is a multicenter, international, cross-sectional study. We collected the MIS-C incidence from the participant regions and countries for the period July 2020 to November 2021. We assessed the ratio between MIS-C cases and COVID-19 pediatric cases in children Transplantation and immunomodulatio

Loxoscelismo en Chile: estudios epidemiológicos, clínicos y experimentales

Se presenta un enfoque panorámico de estudios epidemiológicos, clínicos y experimentales referentes a Loxosceles laeta y loxoscelismo efectuados en 1955-1988 en Santiago, Chile. Se estudiaron 216 casos de loxoscelismo. Los hechos más relevantes fueron: 52,8% correspondió a mujeres; edad entre 7 meses y 78 años; 84,3% fué loxoscelismo cutáneo (LO y 15,7% loxoscelismo cutáneo-visceral (LCV); 73,6% sucedió en época calurosa; en 86,6% el accidente ocurrió en la vivienda, especialmente en dormitorios, mientras la persona dormía o se vestía. La araña fué vista en 60,2% de los casos e identificada en laboratorio como L. laeta en 17,7% (10,6% de los 216 casos). Los sitios más frecuen temente afectados fueron las extremidades con 67,6%, lancetazo urente fué el síntoma inicial más frecuente. Dolor, edema y placa livedoide, la cual posteriormente se transformaría en escara necrótica, fueron las manifestaciones locales predominantes. En LCV hematuria y hemoglobinuria fueron constantes, ictericia, fiebre y compromiso de conciencia se presentaron en la mayoría de los casos. Tratamiento: LC con antihistamínicos o corticoides inyectables, LCV con corti-coides inyectables. La condición de los pacientes en el último control fué: curación completa en 75,5%, curación con secuela cicatrizal en 8,3%, muerte en 3,7% (todos con LCV) y abandono en 12,5%. Adicionalmente, se ha efectuado una serie de estudios experimentales, tanto in vivo como in vitro para esclarecer aspectos básicos sobre el veneno de L. laeta y el tratamiento del loxoscelismo.A panoramic sight of epidemiological, clinical and experimental studies, referring to Loxosceles laeta and loxoscelism, carried out in 1955-1988, in Santiago, Chile is presented. Two-hundred and sixteen cases of loxosce lism were studied. The most relevant features were: 84.3% corresponded to cutaneous loxosce lism (CD and 15.7% to viscerocutaneous loxos celism (VCD; 73.6% ocurred in hot season; in 86.6% of cases the accident happened in the hou se, particularly in bedrooms, while the people were sleeping or dressing. The spider was seen in 60.2%r of cases and identified in the laboratory as L. laeta in 10.69c of all cases. The sites more frequently bitten were the limbs with 67.6% ; a burning stinging was the most frequent initial symptom. Pain, edema and livedoid plaque, which developed later into a necrotic eschar, we re the predominant local manifestations. In VCL, hematuria and hemoglobinuria were cons tant, while jaundice, fever and sensorial involve ment were present in most of the cases. CL patients were parenterally treated with antihistamine drugs or corticoids, while VCL ones were treated with corticoids by injection. The condition of patients in the last follow up was: complete cure in 75.5% , cure with a scarfed sequela in 8.3%, death in 3.7% (all VCL) and abandonment in 12.5%. Additionally, a series of experimental studies, both in vivo and in vitro, has been performed in order to clarify basic aspects on L. laeta venom and the treatment of loxoscelism

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Orbital alveolar rhabdomyosarcoma masked by ethmoid sinusitis in a 25-year-old

Caso clínico: mujer de 25 años con sinusitis subaguda derecha acudió por molestias en ojo derecho. Ante clínica y tomografía urgente sugestiva de absceso subperióstico orbitario etmoidal, se realizó un drenaje urgente, hallándose una tumoración sólida con biopsia positiva para rabdomiosarcoma alveolar. Se inició tratamiento con quimioterapia y radioterapia con remisión completa y resolución del cuadro clínico. Discusión: el rabdomiosarcoma orbitario alveolar en adultos es infrecuente. Presenta un alto riesgo de diseminación y puede debutar simulando una sinusitis, como en este caso, por lo que un diagnóstico y tratamiento precoces son de especial importancia en estos pacientes.0.225 SJR (2014) Q3, 74/111 OphthalmologyUE

Towards inorganic porous materials by design: Looking for new architectures

Crystalline porous materials, such as zeolites and metal-organic frameworks (MOFs), possess a regular and well-defined system of pores. While zeolites have been known for a long time and are widely used in industry, MOFs are still a new type of compounds with a huge potential for numerous applications. MOFs and zeolites may feature certain similarities as well as large differences, but concepts such as flexibility of the framework, thermodynamic versus kinetic control of the crystallization or stabilizing effect of guest species are key issues in both fields. This article presents a vision on the state of the art of such materials. Crystalline porous materials, such as zeolites and metal-organic frameworks, present a very large interest for actual and/or potential technological uses. Their syntheses by design for targeted applications critically depend on the ability to shape their structures and functionalities. This requires a deep understanding of structure-direction issues, whose state of the art is briefly reviewed in this article. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.This work has been supported by the Spanish MICINN Projects Mat 2007-60822, MAT2009-09960, CTQ 2007-28909-E/BQU, CAM: S2009/MAT-1756/CAM, and Consolider-Ingenio CSD2006-2001; AEPP and AR acknowledge JAE fellowship from CSIC and Fondo Social Europeo from EU.Peer Reviewe

Towards inorganic porous materials by design: Looking for new architectures

Crystalline porous materials, such as zeolites and metal-organic frameworks (MOFs), possess a regular and well-defined system of pores. While zeolites have been known for a long time and are widely used in industry, MOFs are still a new type of compounds with a huge potential for numerous applications. MOFs and zeolites may feature certain similarities as well as large differences, but concepts such as flexibility of the framework, thermodynamic versus kinetic control of the crystallization or stabilizing effect of guest species are key issues in both fields. This article presents a vision on the state of the art of such materials. Crystalline porous materials, such as zeolites and metal-organic frameworks, present a very large interest for actual and/or potential technological uses. Their syntheses by design for targeted applications critically depend on the ability to shape their structures and functionalities. This requires a deep understanding of structure-direction issues, whose state of the art is briefly reviewed in this article. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.This work has been supported by the Spanish MICINN Projects Mat 2007-60822, MAT2009-09960, CTQ 2007-28909-E/BQU, CAM: S2009/MAT-1756/CAM, and Consolider-Ingenio CSD2006-2001; AEPP and AR acknowledge JAE fellowship from CSIC and Fondo Social Europeo from EU.Peer Reviewe

Targeting nuclear protein TDP-43 by cell division cycle kinase 7 inhibitors: A new therapeutic approach for amyotrophic lateral sclerosis

58 p.-11 fig.-2 tab.Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease with no known cure. Aggregates of the nuclear protein TDP-43 have been recognized as a hallmark of proteinopathy in both familial and sporadic cases of ALS. Post-translational modifications of this protein, include hyperphosphorylation, cause disruption of TDP-43 homeostasis and as a consequence, promotion of its neurotoxicity. Among the kinases involved in these changes, cell division cycle kinase 7 (CDC7) plays an important role by directly phosphorylating TDP-43. In the present manuscript the discovery, synthesis, and optimization of a new family of selective and ATP-competitive CDC7 inhibitors based on 6-mercaptopurine scaffold are described. Moreover, we demonstrate the ability of these inhibitors to reduce TDP-43 phosphorylation in both cell cultures and transgenic animal models such as C. elegans and Prp-hTDP43 (A315T) mice. Altogether, the compounds described here may be useful as versatile tools to explore the role of CDC7 in TDP-43 phosphorylation and also as new drug candidates for the future development of ALS therapies.This work was supported by Comunidad de Madrid (grant B2017/BMD-3813), MINECO (grant SAF2016-76693-R and PID2019-105600RB-I00 to A.M., RTI2018-0988885-B-I00 to E.dL. and CTQ2015-66313-R to A.M.R.), ISCii CIBERNED (CB18/05/00040 to A.M., C.G. and A.M.R, and CB06/05/0089 to E.dL.), MECD (FPU14-00204. to E.R.), the National Institutes of Health (R01NS064131 to B.C.K.) and the Department of Veterans Affairs (Merit Review Grants I01BX003755 to B.C.K. and I01BX004044 to N.F.L.), CONICYT-PCI (grant REDES190074 to D.R. and A.M.) and FONDECYT (grant no. 11180604 to D.R.).Peer reviewe