Formality of Donaldson submanifolds

We introduce the concept of s-formal minimal model as an extension of formality. We prove that any orientable compact manifold M, of dimension 2n or (2n-1), is formal if and only if M is (n-1)-formal. The formality and the hard Lefschetz property are studied for the symplectic manifolds constructed by Donaldson with asymptotically holomorphic techniques. This study permits us to show an example of a Donaldson symplectic manifold of dimension eight which is formal simply connected and does not satisfy the hard Lefschetz theorem.Comment: 24 pages, no figures, Latex2e; v3. statement of Lemma 2.7 correcte

Solar Degradation of Sulfamethazine Using rGO/Bi Composite Photocatalysts

This work was supported by the Spanish Ministry of Economy, Industry and Competitiveness and by FEDER (CTQ2016-80978-C2−1-R), and the authors thank to Dr. Isabel Guerra Tschuschke for the technical advice during the VP-SEM study at the CIC-UGR.Heterogeneous photocatalysts for water decontamination were obtained by the optimized synthesis of bismuth-functionalized reduced graphene oxide (rGO/Bi) using the Hummer method and microwave treatment. Sulfamethazine (SMZ) was used as model pollutant to evaluate the photocatalytic efficacy. Photocatalysts were characterized by VP-SEM, HRTEM, XDR, XPS, RAMAN, and FTIR analyses, which confirmed the effective reduction of GO to rGO and the presence of bismuth as a crystalline phase of Bi2O3 polydispersed on the surface. Their performance was influenced by the rGO/Bi ratio, microwave temperature, and treatment time. The as-obtained 5%rGO/Bi composite had the highest photocatalytic activity for SMZ degradation under visible light irradiation (λ > 400 nm), achieving 100% degradation after only 2 h of treatment. The degradation yield decreased with higher percentages of rGO. Accordingly, the rGO/Bi catalysts efficiently removed SMZ, showing a high photocatalytic activity, and remained unchanged after three treatment cycles; furthermore, cytotoxicity tests demonstrated the nontoxicity of the aqueous medium after SMZ degradation. These findings support the potential value of these novel composites as photocatalysts to selectively remove pollutants in water treatment plants.Spanish Ministry of Economy, Industry and Competitiveness CTQ2016-80978-C2-1-REuropean Union (EU) CTQ2016-80978-C2-1-

Mascarilla Laríngea AIR-Q

La mascarilla laríngea Air-Q o Intubating Laryngeal Airway (ILA) (Cookgas L.L.C, St. Louis, MO, distribuida por Mercury Medical), diseñada por el Dr. Cook, es un dispositivo supraglótico que permite la intubación a su través. Como sabemos, los dispositivos supraglóticos (DSG) juegan un importante papel en el manejo de la vía aérea (VA) y, a diferencia de otras alternativas a la ventilación estándar como los videolaringoscopios o los estiletes, permiten la ventilación y muchas veces la intubación a través de ellos. En 2.011 Timmermam y col. publicaron una nueva clasificación de los DSG: Primera generación: son tubos de VA. Tipos: mascarilla laríngea clásica y todas las de diseño parecido. Segunda generación: incorporan características de diseño específicas para mejorar la seguridad y proteger contra la regurgitación y aspiración. Tienen un tubo gástrico y un sellado mejor. Tipos: mascarilla laríngea Proseal, ML Supreme, i-gel, SLIPA, etc. Para intubación: permiten la intubación a su través. Tipos: ML. Fastrach (reutilizable y desechable), ML Air-Q (reutilizable, desechable y ML Air-Q sp) Bloqueadores esofágicos: se diseñaron inicialmente para el manejo de la VA de urgencia, principalmente extrahospitalario y para personal que no realiza la intubación de forma habitual. Tipos: combitubo, Easy Tubo, Tubo laríngeo (distintas versiones). Según esta clasificación, incluiríamos las ML Air-Q en el tercer grupo, en la de dispositivos supraglóticos para intubación

Genetic Variability of AdeRS Two-Component System Associated with Tigecycline Resistance in XDR-Acinetobacter baumannii Isolates

The emergence of tigecycline resistance has increased in the last years. Although tigecycline-resistant Acinetobacter baumannii isolates were described all over the world, few reports regarding the molecular basis of this resistance are available. It has been recognized that the overexpression of AdeABC efflux pump is related to the tigecycline-resistant phenotype. In 37 clinical A. baumannii isolates we first determined the tigecycline-resistant phenotype and then, within a selected group, we analyzed the sequence of the adeRS operon, which is involved in the expression of the AdeABC efflux pump. Nucleotide sequence analysis of adeR and adeS showed the presence of 5 and 16 alleles, respectively. These results expose a high genetic variability in both genes, the adeS gene being more susceptible to genetic variation. The presence of 2 AdeR and 2 AdeS new variants were reported. Two of the new AdeRS variants were present in the intermediate and the resistant tigecycline A. baumannii isolates, suggesting a putative role in the development of the observed phenotype. More studies need to be addressed to determine the role of the genetic variability observed in the adeRS operon.Fil: Montaña, Sabrina Daiana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Vilacoba, Elisabet. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Traglia, German Matias. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Almuzara, Marisa. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos ; ArgentinaFil: Pennini, M.. Stamboulian Laboratorio. Unidad Microbiología; ArgentinaFil: Fernández, A.. Universidad Favaloro; Argentina. Fundación Favaloro; ArgentinaFil: Sucari, A.. Stamboulian Laboratorio. Unidad Microbiología; ArgentinaFil: Centron, Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Ramirez, Maria Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones en Microbiología y Parasitología Médica; Argentin

Valoración de la Vía Aérea y elaboración de una estrategia: Adrian Pearce, Jan Shaw. Airway assessement and planning. En NAP4. Report and findings of the 4th national audit project of the royal college of anaesthetists.

En esta publicación se han identificado deficiencias en la valoración de la Vía Aérea (VA) originándose complicaciones severas en el manejo de la misma y en ocasiones, los anestesiólogos no investigan si el paciente ha presentado problemas en cirugías previas. Es de gran importancia la vigilancia de los pacientes y la elaboración de una estrategia cuando se sospeche una Vía Aérea Difícil (VAD). Aunque se han observado situaciones de vía aérea difícil con un manejo correcto, en general el manejo suele ser pobre. La valoración de la (VA) debería ser una práctica rutinaria para el anestesiólogo que explora a su paciente antes de una cirugía y se debe establecer una estrategia (combinación de planes secuenciales y predefinidos, como así lo indican las guías de la ASA y la DAS) por si hubiera algún fallo en el manejo de la VA. También es importante esta valoración en la UCI y en la Urgencia y en pacientes en los que se les va administrar una anestesia regional, porque ésta puede fallar o tener complicaciones y convertirse en una anestesia general

Rotura del neumotaponamiento de un tubo endotraqueal al introducirlo mediante un fibroscopio nasal en una paciente despierta

Presentamos el caso de una mujer de 51 años que va a ser intervenida de una timpanoplastia con mastoidectomí­a, para la extirpación de un colesteatoma, a la que se prevee una posibilidad de intubación difí­cil y buena ventilación con mascarilla facial

Benznidazole in cerebrospinal fluid: A case series of chagas disease meningoencephalitis in hiv-positive patients

Chagas disease reactivation in HIV-positive people is an opportunistic infection with 79 to 100% mortality. It commonly involves the central nervous system (CNS). Early treatment with trypanocidal drugs such as benznidazole (BNZ) is crucial for this severe manifestation of Trypanosoma cruzi infection. However, limited BNZ clinical pharmacology data are available, especially its concentration in the CNS. We report a series of HIV-positive patients undergoing treatment for T. cruzi meningoencephalitis, their clinical response, and cerebrospinal fluid (CSF) and plasma BNZ concentrations. Measurements were carried out using leftover samples originally obtained for routine medical care. A high-performance liquid chromatography/tandem mass spectrometry bioanalytical method designed for BNZ plasma measurements was adapted and validated for CSF samples. Six patients were enrolled in this study from 2015 to 2019. A total of 6 CSF and 19 plasma samples were obtained. Only three of the CSF samples had detectable BNZ levels, all under 1mg/ml. Fifteen plasma samples had detectable BNZ, and 13 were above 2mg/ml, which is the putative trypanocidal level. We observed BNZ concentrations in human CSF and plasma. CSF BNZ concentrations were low or not measurable in all patients, suggesting that the usual BNZ doses may be suboptimal in HIV-positive patients with T. cruzi meningoencephalitis. While drug-drug and drug-disease interactions may be in part responsible, the factors leading to low CSF BNZ levels remain to be studied in detail. These findings highlight the potential of therapeutic drug monitoring in BNZ treatment and suggest that the use of higher doses may be useful for Chagas disease CNS reactivations

Dispositivos Ópticos utilizados en la Vía Aérea Difícil (parte II)

Continuamos con la revisión de los distintos Dispositivos Ópticos (DO) que estamos llevando a cabo y con la que pretendemos simplificar y aglutinar la gran cantidad de DO que existen actualmente en el mercado

High levels of hemoglobin promote carotid adventitial vasa vasorum neoangiogenesis in chronic kidney disease

Chronic kidney disease (CKD) patients, characterized by traditional and nontraditional risk factors, are prone to develop atheromatosis and thus cardiovascular events and mortality. The angiogenesis of the adventitial vasa vasorum (aVV) surrounding the carotid has been described as the atheromatosis initiator. Therefore, the aim of the study was to (1) evaluate if the carotid aVV in CKD patients increases in comparison to its physiological value of healthy patients; (2) explore which traditional or nontraditional risk factor including inflammation, bone and mineral metabolism, and anemia could be related to the aVV angiogenesis. CKD patients without previous cardiovascular events (44, stages 3-4; 37, stage 5D) and 65 healthy subjects were compared. The carotid aVV and the intima-media thickness (cIMT) were evaluated by ultrasound. CKD patients at stages 3-4 showed higher aVV of the right carotid artery even after adjusting for age. Importantly, a multiple linear regression model showed hemoglobin levels > 12.5 g/dL as the factor for an estimated higher aVV of the right carotid artery. In conclusion, the association of hemoglobin with higher aVV could suggest the role of high hemoglobin in the higher incidence of adverse cardiovascular outcomes in CKD patients.This study was funded by the Health Institute Carlos III, Ministry of Economy and Competitiveness, Spain, Grants no. PI09/1999