A method to correct nasal valve dysfunction

El colapso valvular es una causa común de obstrucción respiratoria. Presentamos el caso clínico de una mujer de 62 años con obstrucción nasal derecha. En la exploración física se observó la existencia de una estenosis de vávula nasal de predominio derecho. Se realizó la corrección quirúrgica de la misma mediante la suspensión valvular con hilos de sutura, utilizando una variación de la técnica de Paniello, obteniendo resultados satisfactorios desde la finalización de la cirugía. Proponiéndose esta técnica como una alternativa inicial a los diferentes métodos de corrección quirúrgica existentes hasta el momentoThe nasal alar collapse is a common cause of respiratory obstruction. We report the case of 62 years woman with right nasal obstruction. Physical examination reveals the existence of nasal valve stenosis with right predominance. Surgical correction is performed by the valve suspension with surgical thread, using a variation of the Paniello´s technique, obtaining satisfactory results from the completion of surgery. This technique is proposed as an alternative to the different surgical techniques existing to dat

Retropharyngeal abscess described as a complication of infectious mononucleosis

Se describe un caso de absceso retrofaríngeo como complicación de mononucleosis infecciosa. Paciente adolescente que acudió al servicio de urgencias de nuestro hospital con una masa de crecimiento progresivo retrofaríngeo y cervical que comprometió la vía aérea y requirió intervención quirúrgica bajo anestesia general para su correcto drenaje y control. El diagnostico de mononucleosis infecciosa fue clínico y serológico. La tomografía computerizada (TC) cervical permitió objetivar el compromiso de la vía aérea así como la extensión del procesoWe describe a case of retropharyngeal abscess as a complication of infectious mononucleosis. Adolescent patient attended at the emergency department with a progressively growing retropharyngeal and cervical mass that airway obstruction and required surgery under general anesthesia for drainage and control. The diagnosis of infectious mononucleosis was clinical and serological. Computed tomography (CT) allowed us to evaluate the airway and the extent of the proces

Biomolecular Interaction Analysis of Gestrinone-anti-Gestrinone Using Arrays of High Aspect Ratio SU-8 Nanopillars

In this paper, label-free biosensing for antibody screening by periodic lattices of high-aspect ratio SU-8 nano-pillars (BICELLs) is presented. As a demonstration, the determination of anti-gestrinone antibodies from whole rabbit serum is carried out, and for the first time, the dissociation constant (KD = 6 nM) of antigen-antibody recognition process is calculated using this sensing system. After gestrinone antigen immobilization on the BICELLs, the immunorecognition was performed. The cells were interrogated vertically by using micron spot size Fourier transform visible and IR spectrometry (FT-VIS-IR), and the dip wavenumber shift was monitored. The biosensing assay exhibited good reproducibility and sensitivity (LOD = 0.75 ng/mL).Ortega Higueruelo, FJ.; Bañuls Polo, MJ.; Sanza, FJ.; Casquel, R.; Laguna, MF.; Holgado, M.; López-Romero, D.... (2012). Biomolecular Interaction Analysis of Gestrinone-anti-Gestrinone Using Arrays of High Aspect Ratio SU-8 Nanopillars. 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The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Un método para la corrección de la disfunción de válvula nasal

El colapso valvular es una causa común de obstrucción respiratoria. Presentamos el caso clínico de una mujer de 62 años con obstrucción nasal derecha. En la exploración física se observó la existencia de una estenosis de vávula nasal de predominio derecho. Se realizó la corrección quirúrgica de la misma mediante la suspensión valvular con hilos de sutura, utilizando una variación de la técnica de Paniello, obteniendo resultados satisfactorios desde la finalización de la cirugía. Proponiéndose esta técnica como una alternativa inicial a los diferentes métodos de corrección quirúrgica existentes hasta el momento.El colapso valvular es una causa común de obstrucción respiratoria. Presentamos el caso clínico de una mujer de 62 años con obstrucción nasal derecha. En la exploración física se observó la existencia de una estenosis de vávula nasal de predominio derecho. Se realizó la corrección quirúrgica de la misma mediante la suspensión valvular con hilos de sutura, utilizando una variación de la técnica de Paniello, obteniendo resultados satisfactorios desde la finalización de la cirugía. Proponiéndose esta técnica como una alternativa inicial a los diferentes métodos de corrección quirúrgica existentes hasta el momento

Absceso retrofaringeo como complicación de mononucleosis infecciosa

We describe a case of retropharyngeal abscess as a complication of infectious mononucleosis. Adolescent patient attended at the emergency department with a progressively growing retropharyngeal and cervical mass that airway obstruction and required surgery under general anesthesia for drainage and control. The diagnosis of infectious mononucleosis was clinical and serological. Computed tomography (CT) allowed us to evaluate the airway and the extent of the process.Se describe un caso de absceso retrofaríngeo como complicación de mononucleosis infecciosa. Paciente adolescente que acudió al servicio de urgencias de nuestro hospital con una masa de crecimiento progresivo retrofaríngeo y cervical que comprometió la vía aérea y requirió intervención quirúrgica bajo anestesia general para su correcto drenaje y control. El diagnostico de mononucleosis infecciosa fue clínico y serológico. La tomografía computerizada (TC) cervical permitió objetivar el compromiso de la vía aérea así como la extensión del proceso

Optimization of a label-free biosensor vertically characterized based on a periodic lattice of high aspect ratio SU-8 nano-pillars with a simplified 2D theoretical model

We have recently demonstrated a biosensor based on a lattice of SU8 pillars on a 1 μm SiO2/Si wafer by measuring vertically reflectivity as a function of wavelength. The biodetection has been proven with the combination of Bovine Serum Albumin (BSA) protein and its antibody (antiBSA). A BSA layer is attached to the pillars; the biorecognition of antiBSA involves a shift in the reflectivity curve, related with the concentration of antiBSA. A detection limit in the order of 2 ng/ml is achieved for a rhombic lattice of pillars with a lattice parameter (a) of 800 nm, a height (h) of 420 nm and a diameter(d) of 200 nm. These results correlate with calculations using 3D-finite difference time domain method. A 2D simplified model is proposed, consisting of a multilayer model where the pillars are turned into a 420 nm layer with an effective refractive index obtained by using Beam Propagation Method (BPM) algorithm. Results provided by this model are in good correlation with experimental data, reaching a reduction in time from one day to 15 minutes, giving a fast but accurate tool to optimize the design and maximizing sensitivity, and allows analyzing the influence of different variables (diameter, height and lattice parameter). Sensitivity is obtained for a variety of configurations, reaching a limit of detection under 1 ng/ml. Optimum design is not only chosen because of its sensitivity but also its feasibility, both from fabrication (limited by aspect ratio and proximity of the pillars) and fluidic point of view. (© 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim