Herida antebraquial infectada por Aeromonas hydrophila

Se presenta un caso de celulitis por Aeromonas hydrophila, en un paciente de 23 años, tras una herida antebraquial producida en el medio acuático. La celulitis se resolvió mediante desbridamiento agresivo y quimioterapia. En los controles posteriores no se han apreciado déficits funcionales tras la infección.A case of Aeromonas hidrophila cellulitis developped in a 23-year-old patient, after aquatic environment forearm wound is presented. His cellulitis was effectively resolved with aggressive debridement and chemotherapy. Follow-up examinations have shown no residual functional deficits from the infection

Mechanochemically synthesized Pb-free halide perovskite-based Cs2AgBiBr6–Cu–RGO nanocomposite for photocatalytic CO2 reduction

Pb-based halide perovskites have recently showed great potential in various applications such as solar cells, optoelectronics and photocatalysis. Despite their high performance, the Pb2+ toxicity along with poor stability hinders long term applications in photocatalysis. Herein, we report mechanochemically prepared Pb-free Cs2AgBiBr6 double perovskite nanoplates and their heterostructure with Cu-loaded reduced graphene oxide (Cu–RGO) for gas-phase photocatalytic CO2 reduction using water vapor as the proton source in the absence of a hole scavenger. The resulting Cs2AgBiBr6–Cu–RGO nanocomposite shows significant photocatalytic activity of 10.7 (±0.6) μmol CH4 g−1 h−1, 1.9 (±0.3) μmol CO g−1 h−1 and 1.0 (±0.2) μmol H2 g−1 h−1, with a CH4 selectivity of 93.0 (±0.5)% on an electron basis with 1 sun and a remarkable apparent quantum efficiency of 0.89 (±0.21)% at 590 nm. A further 32% enhancement in photocatalytic activity on an electron basis is achieved when the light intensity is doubled (2 suns). The high performance was attributed to their improved charge separation and suppressed electron–hole recombination, along with extended visible light absorption, better stability in a humid environment and improved CO2 adsorption. These findings support Cs2AgBiBr6 as a potential Pb-free alternative to conventional halide perovskites for photocatalytic solar-to-fuel conversion and CO2 utilization

ZnO/BiOI heterojunction photoanodes with enhanced photoelectrochemical water oxidation activity

ZnO/BiOI heterojunction photoanode thin films were prepared by aerosol-assisted chemical vapour deposition, and the impact of growth temperature and film thickness on the water oxidation functionality was systematically investigated. A top ZnO layer with a thickness of 120 nm (deposited at 350 °C) and a 390 nm thick BiOI layer (deposited at 300 °C) were found to achieve the best photoelectrochemical performance of the heterojunction. The ZnO/BiOI heterojunction exhibited a significant increase in photoelectrochemical activity, with a photocurrent of 0.27 mA·cm−2 observed at 1.1 VRHE (350 nm, 2.58 mW·cm−2), which is ~ 2.2 times higher than that of single-layer ZnO and far higher than that of BiOI. Photoluminescence spectroscopy and transient absorption spectroscopy measurements showed that there was effective charge transfer across the heterojunction which spatially separated charge carriers and increased their lifetime and ability to drive photoelectrochemical water oxidation

Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study

Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician diagnosis of severe sepsis, which underlies external validity for pediatric sepsis research, is not known. We sought to determine the agreement between physician diagnosis and consensus criteria to identify pediatric patients with severe sepsis across a network of international pediatric intensive care units (PICUs). Methods: We conducted a point prevalence study involving 128 PICUs in 26 countries across 6 continents. Over the course of 5 study days, 6925 PICU patients <18 years of age were screened, and 706 with severe sepsis defined either by physician diagnosis or on the basis of 2005 International Pediatric Sepsis Consensus Conference consensus criteria were enrolled. The primary endpoint was agreement of pediatric severe sepsis between physician diagnosis and consensus criteria as measured using Cohen's ?. Secondary endpoints included characteristics and clinical outcomes for patients identified using physician diagnosis versus consensus criteria. Results: Of the 706 patients, 301 (42.6 %) met both definitions. The inter-rater agreement (? ± SE) between physician diagnosis and consensus criteria was 0.57 ± 0.02. Of the 438 patients with a physician's diagnosis of severe sepsis, only 69 % (301 of 438) would have been eligible to participate in a clinical trial of pediatric severe sepsis that enrolled patients based on consensus criteria. Patients with physician-diagnosed severe sepsis who did not meet consensus criteria were younger and had lower severity of illness and lower PICU mortality than those meeting consensus criteria or both definitions. After controlling for age, severity of illness, number of comorbid conditions, and treatment in developed versus resource-limited regions, patients identified with severe sepsis by physician diagnosis alone or by consensus criteria alone did not have PICU mortality significantly different from that of patients identified by both physician diagnosis and consensus criteria. Conclusions: Physician diagnosis of pediatric severe sepsis achieved only moderate agreement with consensus criteria, with physicians diagnosing severe sepsis more broadly. Consequently, the results of a research study based on consensus criteria may have limited generalizability to nearly one-third of PICU patients diagnosed with severe sepsis

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

ZnO/BiOI heterojunction photoanodes with enhanced photoelectrochemical water oxidation activity

ZnO/BiOI heterojunction photoanode thin films were prepared by aerosol-assisted chemical vapour deposition, and the impact of growth temperature and film thickness on the water oxidation functionality was systematically investigated. A top ZnO layer with a thickness of 120 nm (deposited at 350 °C) and a 390 nm thick BiOI layer (deposited at 300 °C) were found to achieve the best photoelectrochemical performance of the heterojunction. The ZnO/BiOI heterojunction exhibited a significant increase in photoelectrochemical activity, with a photocurrent of 0.27 mA·cm−2 observed at 1.1 VRHE (350 nm, 2.58 mW·cm−2), which is ~ 2.2 times higher than that of single-layer ZnO and far higher than that of BiOI. Photoluminescence spectroscopy and transient absorption spectroscopy measurements showed that there was effective charge transfer across the heterojunction which spatially separated charge carriers and increased their lifetime and ability to drive photoelectrochemical water oxidation

Linear assembly of lead bromide-based nanoparticles inside lead(ii) polymers prepared by mixing the precursors of both the nanoparticle and the polymer

Mixing precursors of lead(ii) polymers with those of lead bromide-based nanoparticles (CH3NH3PbBr3 perovskites or PbBr2), at room temperature and in the presence of cyclohexanemethylammonium bromide, generated colloidal nanocomposites which, when deposited on a hydrophobic surface led to long, one-dimensional, ordered and well-defined architectures.status: publishe

Oligoethylene glycol side chains increase charge generation in organic semiconductor nanoparticles for enhanced photocatalytic hydrogen evolution

Organic semiconductor nanoparticles (NPs) composed of an electron donor/acceptor (D/A) semiconductor blend have recently emerged as an efficient class of hydrogen-evolution photocatalysts. It is demonstrated that using conjugated polymers functionalized with (oligo)ethylene glycol side chains in NP photocatalysts can greatly enhance their H2-evolution efficiency compared to their nonglycolated analogues. The strategy is broadly applicable to a range of structurally diverse conjugated polymers. Transient spectroscopic studies show that glycolation facilitates charge generation even in the absence of a D/A heterojunction, and further suppresses both geminate and nongeminate charge recombination in D/A NPs. This results in a high yield of photogenerated charges with lifetimes long enough to efficiently drive ascorbic acid oxidation, which is correlated with greatly enhanced H2-evolution rates in the glycolated NPs. Glycolation increases the relative permittivity of the semiconductors and facilitates water uptake. Together, these effects may increase the high-frequency relative permittivity inside the NPs sufficiently, to cause the observed suppression of exciton and charge recombination responsible for the high photocatalytic activities of the glycolated NPs