The Long-Term Results of Frontalis Suspension Using Autogenous Fascia Lata in Children with Congenital Ptosis under 3 Years Old

Purpose. To describe the long-term results of frontalis suspension using autogenous fascia lata in children with congenital ptosis under 3 years old. Methods. Forty three-eyes of 35 patients were enrolled in the study. Frontalis suspension using autogenous fascia lata was performed in all patients. The postoperative eyelid level, ptosis recurrence, visual acuity, and cosmetic results were evaluated. Results. The mean age of the patients was 16.8 ± 9 months (7–36 months). The mean follow-up time was 52.8 ± 15 months (14–95 months). All patients had good (ptosis <2 mm) or moderate (2-3 mm ptosis) eyelid level after the operation. All patients achieved satisfactory cosmetic results. Succesfull harvesting was performed in all cases and no additional materials or surgical manipulation were needed during the surgery. Conclusion. Frontalis suspension using autogenous fascia lata can be used in children under 3 years old without harvesting problems. Surgical experience and good knowledge of anatomy are important factors for successful results after the surgery

Rubén Darío: "De invierno"

Sin resume

Protein-Protein Association in Polymer Solutions: From Dilute to Semidilute to Concentrated

AbstractIn a typical cell, proteins function in the crowded cytoplasmic environment where 30% of the space is occupied by macromolecules of varying size and nature. This environment may be simulated in vitro using synthetic polymers. Here, we followed the association and diffusion rates of TEM1-β-lactamase (TEM) and the β-lactamase inhibitor protein (BLIP) in the presence of crowding agents of varying molecular mass, from monomers (ethylene glycol, glycerol, or sucrose) to polymeric agents such as different polyethylene glycols (PEGs, 0.2–8 kDa) and Ficoll. An inverse linear relation was found between translational diffusion of the proteins and viscosity in all solutions tested, in accordance with the Stokes-Einstein (SE) relation. Conversely, no simple relation was found between either rotational diffusion rates or association rates (kon) and viscosity. To assess the translational diffusion-independent steps along the association pathway, we introduced a new factor, α, which corrects the relative change in kon by the relative change in solution viscosity, thus measuring the deviations of the association rates from SE behavior. We found that these deviations were related to the three regimes of polymer solutions: dilute, semidilute, and concentrated. In the dilute regime PEGs interfere with TEM-BLIP association by introducing a repulsive force due to solvophobic preferential hydration, which results in slower association than predicted by the SE relation. Crossing over from the dilute to the semidilute regime results in positive deviations from SE behavior, i.e., relatively faster association rates. These can be attributed to the depletion interaction, which results in an effective attraction between the two proteins, winning over the repulsive force. In the concentrated regime, PEGs again dramatically slow down the association between TEM and BLIP, an effect that does not depend on the physical dimensions of PEGs, but rather on their mass concentration. This is probably a manifestation of the monomer-like repulsive depletion effect known to occur in concentrated polymer solutions. As a transition from moderate to high crowding agent concentration can occur in the cellular milieu, this behavior may modulate protein association in vivo, thereby modulating biological function

Patient Safety Training in Pediatric Emergency Medicine: A National Survey of Program Directors

Objectives The Accreditation Council for Graduate Medical Education requires training in patient safety and medical errors but does not provide specification for content or methods. Pediatric emergency medicine ( EM ) fellowship directors were surveyed to characterize current training of pediatric EM fellows in patient safety and to determine the need for additional training. Methods From June 2013 to August 2013, pediatric EM fellowship directors were surveyed via e‐mail. Results Of the 71 eligible survey respondents, 57 (80.3%) completed surveys. A formal curriculum was present in 24.6% of programs, with a median of 6 hours (range = 1 to 18 hours) dedicated to the curriculum. One program evaluated the efficacy of the curriculum. Nearly 91% of respondents without formal programs identified lack of local faculty expertise or interest as the primary barrier to implementing patient safety curricula. Of programs without formal curricula, 93.6% included at least one component of patient safety training in their fellowship programs. The majority of respondents would implement a standardized patient safety curriculum for pediatric EM if one was available. Conclusions Despite the importance of patient safety training and requirements to train pediatric EM fellows in patient safety and medical errors, there is a lack of formal curriculum and local faculty expertise. The majority of programs have introduced components of patient safety training and desire a standardized curriculum. Resumen Objetivos El Accreditation Council for Graduate Medical Education exige formación en seguridad del paciente y errores médicos, pero no proporciona especificaciones de los contenidos o los métodos. Se encuestó a los directores del programa de posresidencia en Medicina de Urgencias y Emergencias ( MUE ) Pediátrica para caracterizar acerca de la formación actual de los adjuntos de MUE Pediátrica en seguridad del paciente, para intentar determinar la necesidad de formación adicional. Metodología Se encuestó mediante correo electrónico a los directores del programa de posresidencia de MUE Pediátrica de junio de 2013 a agosto de 2013. Resultados De los 71 respondedores elegibles de la encuesta, 57 (80,3%) la completaron. Existía un plan de estudios formal en un 24,6% de los programas, con una mediana de 6 horas (rango de 1 a 18 horas) dedicadas en el plan de estudios. Un programa evaluó la eficacia del plan de formación. Casi un 91% de los respondedores sin un programa formal identificó una falta de experiencia o interés de los profesores locales como la barrera principal para implementar un plan de estudios sobre la seguridad del paciente. De los programas sin un plan de estudios formal, un 93,6% incluyó al menos un componente de formación en seguridad del paciente en su programa de posresidencia. La mayoría de los respondedores implementarían un plan de estudios estandarizado sobre seguridad del paciente en MUE Pediátrica si existiera alguno disponible. Conclusiones A pesar de la importancia de la formación en seguridad del paciente y los requisitos para formar a los adjuntos de MUE Pediátrica en seguridad del paciente y errores médicos, hay una falta de plan de estudios formal y de experiencia de profesores locales. La mayoría de los programas ha introducido componentes de formación en seguridad del paciente y desean un plan de estudios estandarizado.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108264/1/acem12418.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/108264/2/acem12418-sup-0001-DataSupplementS1.pd

Znaczenie wsparcia społecznego dla poziomu lęku i depresji oraz obciążenia opiekunów pacjentów po udarze mózgu – wyniki wstępne

Background. Stroke is a medical emergency, it occurs suddenly, putting the patient and his family in a new, unexpected and extremely stressful situation. About 70 000 people suffer stroke every year in Poland and the number is constantly increasing. Potential intervening factor, which influenced functioning of caregivers of patients with stroke may be social support, in the form of a health educational program.Aim. The aim of the study was to determine the importance of social support in the form of health educational program for anxiety and depression level and burden of stroke patients’ caregivers.Material and methods. The study group consisted of 22 caregivers (family members) of the patients hospitalized in the Department of Neurology for Adults, Medical University Hospital in Gdansk, with a stroke or TIA. The study was conducted in the period from January 2008 to February 2010. The research method was preexperimental study, one-group pretest-posttest design, without a control group. The evaluation assessed the level of anxiety and depression among caregivers and the level of caregivers burden load level (3 and 6-12 months after the occurrence of stroke in a close relative), the study compared with baseline during hospitalization.Results. The level of anxiety among caregivers ranged on the border between the lack of disturbance (0-7 pts.) and the symptoms of borderline (8-10 pts.). Based on the HADS scale there was no depression in this group. The level of emotional exhaustion in the group of careers was at the average level. However, depersonalization among caregivers performed at a low level. Caregivers highly evaluated their capabilities, to provide care for stroke relatives.Conclusions. 1. When the time passes from the occurrence of the incident stroke, the level of anxiety and depression among caregivers decreased. In the first study, the level of caregivers’ anxiety was significantly lower in the case of better functional status of the patient. 2. In the research population, there were no high-level of burden. 3. With the improvement of neurological and functional status of the stroke patients, the level of emotional exhaustion significantly decreased and significantly increased assessment of own capabilities of taking care. 4. In the study population of caregivers reported no high-level of burden. There was no statistically significant differences in the impact of applied health educational program on the level of anxiety and depression and caregivers burden. (PNN 2013;2(1):18-26)Wprowadzenie. Udar mózgu jest stanem zagrożenia życia, występuje nagle, stawiając chorego i jego rodzinę w nowej, niespodziewanej oraz niezwykle stresującej sytuacji. Rocznie w Polsce na udar mózgu zapada około 70 tys. osób i liczba ta stale wzrasta. Potencjalnym czynnikiem interwencyjnym wpływającym na funkcjonowanie opiekunów pacjentów po udarze mózgu może okazać się wsparcie społeczne, w formie programu edukacji zdrowotnej.Cel. Określenie znaczenia wsparcia społecznego, w formie programu edukacji zdrowotnej, dla poziomu lęku i depresji oraz obciążenia opiekunów pacjentów po udarze mózgu.Materiał i metody. Grupę badawczą stanowiło 22 opiekunów (członkowie rodzin) pacjentów hospitalizowanych w Klinice Neurologii Dorosłych UCK w Gdańsku, z powodu udaru mózgu bądź TIA. Badania przeprowadzono w okresie od stycznia 2008 roku do lutego 2010 roku. Zastosowano metodę preekseprymentalną (ang. preexperimental study), schemat jednogrupowy z dwukrotnym pomiarem (ang. one-group pretest-posttest design), bez grupy kontrolnej. Ocenie poddano poziom lęku i depresji oraz poziom obciążenia opiekunów, po upływie 3 i 6-12 miesięcy od chwili wystąpienia udaru mózgu u osoby bliskiej, w porównaniu z badaniem wyjściowym podczas hospitalizacji chorego.Wyniki. Poziom lęku wśród opiekunów wahał się na granicy między brakiem zaburzeń (0-7 pkt.) a objawami granicznymi (8-10 pkt.). W oparciu o skalę HADS nie odnotowano zaburzeń depresyjnych w tej grupie. Poziom wyczerpania emocjonalnego w badanej grupie opiekunów kształtował się na średnim poziomie. Natomiast depersonalizacja wśród opiekunów występowała na niskim poziomie. Opiekunowie chorych po udarze mózgu wysoko oceniali własne możliwości, co do sprawowania opieki na bliskim.Wnioski. 1. Wraz z upływem czasu od wystąpienia incydentu naczyniowego zaobserwowano obniżenie poziomu lęku i depresji wśród opiekunów. W pierwszym badaniu poziom lęku opiekuna był istotnie niższy w przypadku lepszego stanu funkcjonalnego pacjenta. 2. W badanej populacji opiekunów nie odnotowano wysokiego poziomu obciążenia. 3. Wraz z poprawą stanu funkcjonalnego i neurologicznego pacjenta, obniżał się istotnie poziom wyczerpania emocjonalnego opiekuna oraz istotnie zwiększała się ocena jego możliwości, co do sprawowania opieki. 4. Nie uzyskano istotnych statystycznie różnic w zakresie wpływu zastosowanego programu edukacji zdrowotnej na poziom lęku i depresji oraz obciążenia opiekunów pacjentów po udarze mózgu. (PNN 2013;2(1):18-26

Investigation of the Systems Сu(Ag)In5S8 − FeIn2S4

Використовуючи методи диференційно-термічного та рентгенофазового аналізів, досліджено фазові рів- новаги перерізів Сu(Ag)In5S8 – FeIn2S4. Сполуки СuIn5S8 та AgIn5S8 утворюють НРТР зі сполукою FeIn2S4. Пере- різ AgIn5S8 – FeIn2S4 є квазібінарним (І тип за класифікацією Розебома), СuIn5S8 − FeIn2S4 є частково квазібі- нарним, що зумовлено інконгруентним типом утворення СuIn5S8. Ці сполуки кристалізуються в структурному типі шпінели (ПГ Fd 3 m). Using differential thermal and X-ray phase analysis methods, phase equilibria at the Сu(Ag)In5S8 − FeIn2S4 section were investigated. Compounds СuIn5S8 and AgIn5S8 forms continuous solid solution series with FeIn2S4. The section AgIn5S8 − FeIn2S4 is quasi-binary (belongs to Roozeboom I type), section СuIn5S8 − FeIn2S4 is partially non-quasibinary due to the incongruent type of the formation of СuIn5S8. The all compounds has crystal structure of the spinel type (S.G. Fd3 m)

Benzylic Dehydroxylation of Echinocandin antifungal drugs restores efficacy against resistance conferred by mutated Glucan Synthase

Each year, infections caused by fungal pathogens claim the lives of about 1.6 million people and affect the health of over a billion people worldwide. Among the most recently developed antifungal drugs are the echinocandins, which noncompetitively inhibit β-glucan synthase, a membrane-bound protein complex that catalyzes the formation of the main polysaccharide component of the fungal cell wall. Resistance to echinocandins is conferred by mutations in FKS genes, which encode the catalytic subunit of the β-glucan synthase complex. Here, we report that selective removal of the benzylic alcohol of the nonproteinogenic amino acid 3S,4S-dihydroxy-l-homotyrosine of the echinocandins anidulafungin and rezafungin, restored their efficacy against a large panel of echinocandin-resistant Candida strains. The dehydroxylated compounds did not significantly affect the viability of human-derived cell culture lines. An analysis of the efficacy of the dehydroxylated echinocandins against resistant Candida strains, which contain mutations in the FKS1 and/or FKS2 genes of the parental strains, identified amino acids of the Fks proteins that are likely to reside in proximity to the l-homotyrosine residue of the bound drug. This study describes the first example of a chemical modification strategy to restore the efficacy of echinocandin drugs, which have a critical place in the arsenal of antifungal drugs, against resistant fungal pathogens.The authors thank J. Berman and D. Perlin for providing Candida strains. This work was supported by the Israel Science Foundation Grant 179/19 (Micha Fridman). TG acknowledges support from the Spanish Ministry of Science and Innovation for grant PGC2018-099921-B-I00 and from the “la Caixa” Foundation under the agreements LCF/PR/GN18/50310010 and LCF/PR/HR21/00737. They also thank E. Ainbinder. O. Singer, and Y. Fried from the Stem Cell Unit of Life Science Core Facilities, the Weizmann Institute of Science. They especially thank H. Barr, head of HTS and Medicinal Chemistry Units at the Maurice and Vivienne Wohl Institute for Drug Discovery, The Nancy and Stephen Grand Israel National Center for Personalized Medicine, Weizmann Institute of Science.Peer ReviewedPostprint (published version

The Phase Equilibria in the Quasiternary System Ag 2 Se–Ga 2 Se 3 –ZnSe.

Система Ag2Se–Ga2Se3–ZnSe досліджувалася методами РФА та ДТА аналізу. Для даної системи характерна складна взаємодія фаз із утворенням твердих розчинів значної протяжності. Для системи Ag2Se–Ga2Se3–ZnSe характерне утворення твердого розчину значної протяжності на основі Ga2Se3. The system Ag2Se–Ga2Se3–ZnSe was probed the methods of RFA and DTA of analysis. For this system the characteristic difficult co-operating of phases is with formation of hard solutions of considerable slowness. For the system Ag2Se–Ga2Se3–ZnSe characteristic formation of hard solution of considerable slowness is on the basis of Ga2Se3