Aplicación de la terapia de oxigenación por membrana extracorpórea neonatal/pediátrica

La oxigenación por membrana extracorpórea se trata de una técnica de rescate de reciente aplicación utilizada tras el fracaso del tratamiento convencional en patologías de carácter reversible, dando tiempo a la recuperación de la patología base, ya sea de origen cardiaco y/o respiratorio. El objetivo de esta revisión bibliográfica es conocer los beneficios de la aplicación del ECMO en la población neonatal/pediátrica. Para ello, se realizó una búsqueda bibliográfica entre diciembre de 2017 y abril de 2018 en bases de datos (Scielo, Lilacs, Medline, Cochrane, Pubmed), bibliotecas online (biblioteca de la Universidad de Valladolid) y buscadores online (Google Académico). Además, se realizó una visita informativa al Hospital “La paz” de Madrid en diciembre de 2017. Tras la aplicación de los criterios de inclusión, lectura pormenorizada de cada uno de ellos y aplicación de las listas de comprobación, fueron seleccionados 18 artículos. Como resultados de esta revisión, cabe destacar el desarrollo de una técnica cada vez más sofisticada y en continuo crecimiento exponencial, donde la población neonatal-pediátrica se muestra especialmente beneficiada. La ELSO, afirma que se ha proporcionado soporte extracorpóreo a un total de 38.994 pacientes, de los cuales el 94% se corresponde a pacientes neonatales y pediátricos. En segundo lugar, los mejores resultados pertenecen a la modalidad respiratoria, a pesar de ello, la indicación de la forma cardiaca es cada vez más prevalente. Resultan evidentes los beneficios obtenidos en ciertas patologías de origen cardiaco y respiratorio, de estas últimas la HDC y el SAM. A pesar de todo lo anterior, existe necesidad de investigación en el campo neonatal, con el objetivo de disponer de la mejor evidencia y poder crear una serie de protocolos asistenciales estandarizados.Grado en Enfermerí

Study of the thermal behavior of sewage sludge from a WWTP in Cantabria (Spain) by TG-DSC-MS

According to European Directive and national regulations in Spain, techniques based on thermal decomposition are proposed for the sewage sludge disposal. In this work, the sludge from the wastewater treatment plant (WWTP) of Casar de Periedo, in Cantabria (Spain) is studied by Thermogravimetry – Differential Scanning Calorimetry – Mass Spectrometry (TG –DSC – MS). A sample of this sludge was submitted, after drying, to different atmospheres: 100 % He, N2 /air or He/air 80/20 and 100 % air, from 20 to 900 ºC, to study primary decomposition reactions in pyrolysis, gasification and combustion respectively. The purpose was to determine the weight loss at different temperatures, the heat flow at each atmosphere and the presence of some gas products like H2, CO, CO2, CH4, or HCl, SO2, SO3, NO and NO2 released, these last five gases to know the contaminants emitted. Combustion conditions (air) rend the greatest mass loss and energy production. Reactions take place at lower temperatures, being mainly CO2 and H2O the products detected in MS, with little amounts of CH4, as it is expected for mainly total oxidation reactions. In gasification conditions, essayed with two atmospheres (N2-air and He-air), quantitative results found are similar, but the highest thermal conductivity of He produces exothermic reactions at lower temperatures, observed in the mass loss and heat flow profiles. From reactions of decomposition, partial oxidation and total oxidation, CO2, H2, H2O and CH4, were identified by MS. Pyrolysis conditions (He) produce the lowest mass loss and slightly endothermic reactions, mainly because of decomposition reactions. Higher H2 amounts were obtained at higher temperatures than in gasification conditions. No gas contaminant (HCl, SO2, SO3, NO and NO2) has been detected by MS, considering this sewage sludge as a “clean sludge”. Comparing the thermal behaviour of the sewage sludge of this plant to that obtained in the WWTP of Santander, the sludge from Casar de Periedo is more appropriated to thermal valorization.We are thankful to MICINN in Spain, National Plan for scientific Research, Development and innovation, for financial support under Project: MAT2010-18862

CO2 capture by amino-functionalized graphene oxide

Human activity is increasing CO2 atmospheric concentration contributing to global warming. In this situation CO2 reversible capture and storage, what it is known as carbon capture and conversion (CCC), can be part of the solution. In this context, searching for a suitable material for this application is necessary. The present study was carried out to investigate the CO2adsorption of amino-functionalized graphene oxide on its surface. Amino-functionalized graphene oxide samples were prepared by different methods with two kind of molecules: 3-aminopropyltrimethoxysilane (APTMS) and polyethylenimine (PEI). A characterization study of the prepared samples was done with thermal analysis, thermogravimetry (TG) and differential scanning calorimetry (DSC), and X-ray photoelectron spectroscopy (XPS). To evaluate the CO2adsorption of the samples CO2 adsorption isotherms were done. These isotherms correspond with a type I and shows an improvement in CO2 chemisorption regarding graphene oxide.This work was supported by “Help Industrial Doctorate” granted by the University of Cantabria in its 2014 call associated with the project Nº 51.DI03.648 and it is gratefully acknowledged

Tunable interlayer hydrophobicity in a nanostructured high charge organo-mica

A tunable hydrophobicity, from a fully hydrophobic medium to an amphiphilic quasi-solution, has been obtained in the interlayer space of a synthetic high charged mica by ion exchange reaction with amine cations. The structural and intercalation properties of the hybrids after the exchange with the n-alkylammonium cations: [RNH3]+, [RNH(CH3)2]+ and [RN(CH3]3+ with C16 alkyl chain length have been determined by termogravimetric/differential scanning calorimetry analysis (TGA-DSC) and mass spectrometry (MS), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). Transmission electron microscopy (TEM) has been used as a complementary technique to provide new insights into the morphology of the exchanged products. Coverage and cation distribution have been correlated with layer charge and steric effects. Thus, a full organo-clay is obtained when the primary amine cations are adsorbed between the layers. However, a homogenous single phase of mixed organic/inorganic cations is formed in the same interlayer with the tertiary amine cations. Mixed ion clays combining both exchangeable inorganic and adsorbent organic ions in their interlayer space can be potential materials to be used as adsorbents for water decontamination, independently of the hydrophilic/hydrophobic nature of the pollutants. For the quaternary amine cations steric effects preclude the coexistence of both organic and inorganic species in the same interlayer of the clay so phase segregation together with a heterogeneous phase of organic and inorganic galleries in the same particle can be observed.Funding from the Ministerio de Economía y Competitividad, under project MAT2015-63929-R is also acknowledged. Fernando Aguado received funding from the Ministerio de Economía y Competitividad, project MAT2015-69508-P

Adsorptive capture of ionic and non-ionic pollutants using a versatile hybrid amphiphilic-nanomica

A versatile, functional nanomaterial for the removal of ionic and non-ionic pollutants is presented in this work. For that purpose, the high charge mica Na-4-Mica was exchanged with the cationic surfactant (C16H33NH(CH3)2)+. The intercalation of the tertiary amine in the swellable nano-clay provides the optimal hydrophilic/hydrophobic nature in the bidimensional galleries of the nanomaterial responsible for the dual functionality. The organo-mica, made by functionalization with C16H33NH3+, was also synthesized for comparison purposes. Both samples were characterized by X-ray diffraction techniques and transmission electron microscopy. Then, the samples were exposed to a saturated atmosphere of cyclohexylamine for two days, and the adsorption capacity was evaluated by thermogravimetric measurements. Eu3+ cations served as a proof of concept for the adsorption of ionic pollutants in an aqueous solution. Optical measurements were used to identify the adsorption mechanism of Eu3+ cations, since Eu3+ emissions, including the relative intensity of different f–f transitions and the luminescence lifetime, can be used as an ideal spectroscopic probe to characterize the local environment. Finally, the stability of the amphiphilic hybrid nanomaterial after the adsorption was also tested.We would like to thank IDIVAL for financial support, project number INNVAL19/1

Use of TG-DSC-MS and gas analyzer data to investigate the reaction of CO2 and SO2 with Ca(OH)2 at low temperature

To investigate the reaction of calcium hydroxide with CO2 and SO2 simultaneously, a gas containing both gases reacted with the calcium base at 58 ºC and a relative humidity of 55 %. Different CO2 and SO2 concentrations were performed being the composition of the gas stream 12, 6 or 0 % CO2; 5000, 2500, 1000 or 0 ppm SO2, 9.5 % synthetic air and balanced N2, with a flue gas rate of 1000 mL/minute. A continuous gas analyzer controlled the CO2 and SO2 concentrations in the effluent gas and the breakthrough curves of both gases were obtained. The gas analyzer data show that SO2 and CO2 compete to react with the base reacting simultaneously. By using thermogravimetry (TG), differential scanning calorimetry (DSC) and mass spectrometry (MS) techniques, calcium sulphite hemihydrate, CaSO3.1/2H2O, was identified as the unique desulfurization product detected. CaSO4 was not identified although O2 was present in the gas mixture. CaCO3 was the main product of the reaction of calcium hydroxide and CO2 being the complex CaO.CO2 another possible product synthesized in low amounts. From analyzer data it was proved that a part of the CaCO3 present in the sorbent or synthesized in the process reacts with the SO2 and release CO2. Results of this work show that the combination of continuous gas analyzer data and TG-DSC-MS techniques, not used before to study this reaction, is a good and easy way to clarify the process and the products of reaction.Our acknowledgment to M.C. y T. for financial support of this work under Project MAT 2010-18862

CO2 capture at low temperature by nanoporous silica modified with amine groups

MCM-41 and SBA-15 were chosen as nanoporous materials based on silica for its modification with aminegroups. This modification was done by two methods: grafting method and wet impregnation method. The firstmethod grafted-amine groups by chemical reaction between surface silanol groups in the nanoporousmaterials and 3-aminopropyltrimetoxilane (APTMS).In the wet impregnation method, low molecular weightpolyethylenimine (PEI) is incorporated trough this method. These modified materials capture CO2 at lowtemperature. CO2 capture on the sorption sites by amine loading is believed to occur via chemisorptionmechanism by formation of ammonium carbamate. The evaluation and analysis of CO2 adsorption was carriedout by two methods: static mode and dynamic mode. The static mode is a pure CO2 adsorption-desorptionisotherms at 298K. The isotherms of the functionalized materials show a behavior by chemisorption, captureat low pressure, being the desorption branch almost horizontal, while nanoporous silica isotherms is due aphysical adsorption, low CO2 capture at low pressure and dependence with pressure, a complete reversibilityof the desorption process. The dynamic mode is a thermogravimetry study at different N2/CO2 concentrations.Isothermal CO2 captures at 298K were carried out to evaluate the suitability of the samples for cyclicoperation. The mass increase during the capture step was interpreted as CO2 adsorption capacity of thesamples. The results obtained by both methods were compared, and, its differences were analyzed

Biodegradable multi-walled carbon nanotubes trigger anti-tumoral effects

Carbon nanotubes are of huge biotechnological interest because they can penetrate most biological barriers and, inside cells, can biomimetically interact with the cytoskeletal filaments, triggering anti-proliferative and cytotoxic effects in highly dividing cells. Unfortunately, their intrinsic properties and bio-persistence represent a putative hazard that relapses their application as therapies against cancer. Here we investigate mild oxidation treatments to improve the intracellular enzymatic digestion of MWCNTs, but preserving their morphology, responsible for their intrinsic cytotoxic properties. Cell imaging techniques and confocal Raman spectroscopic signature analysis revealed that cultured macrophages can degrade bundles of oxidized MWCNTs (o-MWCNTs) in a few days. The isolation of nanotubes from these phagocytes 96 hours after exposure confirmed a significant reduction of approximately 30% in the total length of these filaments compared to the control o-MWCNTs extracted from the cell culture medium, or the intracellular pristine MWCNTs. More interestingly, in vivo single intratumoral injections of o-MWCNTs triggered ca. 30% solid melanoma tumour growth-inhibitory effects while displaying significant signs of biodegradation at the tumoral/peri-tumoral tissues a week after the therapy has had the effect. These results support the potential use of o-MWCNTs as antitumoral agents and reveal interesting clues of how to enhance the efficient clearance of in vivo carbon nanotubes.This work has been supported by the Spanish MINECO and European Union FEDER under Projects ref. PI13/01074, PI16/000496, MAT2015-69508-P, the NanoBioApp Network Ref. MINECO-17-MAT2016-81955-REDT, IDIVAL Projects ref. INNVAL15/16, INNVAL 17/11, PREVAL 16/03, and the Raman4clinics BMBS COST Action BM1401

Clinical presentation of acute coronary syndrome in patients previously treated with nitrates

Aims: Several reports have suggested that nitrates limit acute ischaemic damage by a mechanism similar to preconditioning. This study aims to evaluate the effect of chronic oral nitrates on the clinical presentation and short-term outcomes of patients admitted with acute coronary syndrome (ACS).Methods: A retrospective cohort study was conducted in patients with ACS admitted to 62 acute care units from 2010 to 2011. A propensity score-matched samples analysis was performed.Results: We analysed 3171 consecutive patients, of whom 298 (9.4%) were chronically treated with nitrates. Patients previously treated with nitrates had higher comorbidity and disease severity at admission, lower prevalence of ACS with ST elevation, lower troponin elevation, higher prevalence of initial Killip class 2-4 and higher hospital mortality. The propensity score-matched analysis confirmed that previous use of nitrates is independently associated with a lower prevalence of ST-elevation ACS [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.36-0.78; P = 0.0014] and a lower troponin elevation (OR 0.61, 95% CI 0.41-0.92) but not with Killip class on admission (OR 1.18, 95% CI 0.83-1.67, P = 0.3697) or mortality (OR 0.71, 95% CI 0.37-1.38, P = 0.3196).Conclusion: The results support the hypothesis that nitrates have a protective effect on acute ischaemic injury

Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients

Producción CientíficaBackground: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. Methods: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. Results: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). Conclusion: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.Instituto de Salud Carlos III (grants PI15/01959, PI15/01451 and PI16/01156