A Polarity-Sensitive Far-Red Fluorescent Probe for Glucose Sensing through Skin.

The field of glucose biosensors for diabetes management has been of great interest over the past 60 years. Continuous glucose monitoring (CGM) is important to continuously track the glucose level to provide better management of the disease. Concanavalin A (ConA) can reversibly bind to glucose and mannose molecules and form a glucose biosensor via competitive binding. Here, we developed a glucose biosensor using ConA and a fluorescent probe, which generated a fluorescent intensity change based on solvatochromism, the reversible change in the emission spectrum dependent on the polarity of the solvent. The direction in which the wavelength shifts as the solvent polarity increases can be defined as positive (red-shift), negative (blue-shift), or a combination of the two, referred to as reverse. To translate this biosensor to a subcutaneously implanted format, Cyanine 5.5 (Cy5.5)-labeled small mannose molecules were used, which allows for the far-red excitation wavelength range to increase the skin penetration depth of the light source and returned emission. Three Cy5.5-labeled small mannose molecules were synthesized and compared when used as the competing ligand in the competitive binding biosensor. We explored the polarity-sensitive nature of the competing ligands and examined the biosensor's glucose response. Cy5.5-mannotetraose performed best as a biosensor, allowing for the detection of glucose from 25 to 400 mg/dL. Thus, this assay is responsive to glucose within the physiologic range when its concentration is increased to levels needed for an implantable design. The biosensor response is not statistically different when placed under different skin pigmentations when comparing the percent increase in fluorescence intensity. This shows the ability of the biosensor to produce a repeatable signal across the physiologic range for subcutaneous glucose monitoring under various skin tones.

Cardiovascular diagnostic methods in patients with diabetes mellitus. A review.

Cardiovascular diseases are the most common cause of mortality in the world. Currently, type 2 diabetes mellitus (T2DM) is one of the main risk factors for major adverse cardiovascular events. T2DM patients have a four-fold higher risk of developing heart failure and 10 to 12 times higher mortality. Echocardiography in all its modalities is the best clinical tool for heart failure diagnosis, since it provides static and dynamic images of the heart that allow to identify structural and functional changes, such as pressure variations, flow changes, left ventricular ejection fraction and myocardial surfaces anatomical remodeling.

Las enfermedades cardiovasculares constituyen la causa más común de mortalidad en el mundo. Actualmente, la diabetes mellitus tipo 2 (DM2) representa uno de los principales factores de riesgo de eventos adversos cardiovasculares mayores. Los pacientes que las padecen tienen un riesgo cuatro veces mayor de desarrollar insuficiencia cardíaca y una mortalidad de 10 a 12 veces mayor. La ecocardiografía en todas sus modalidades es la mejor herramienta clínica para el diagnóstico de la insuficiencia cardíaca, ya que proporciona imágenes estáticas y dinámicas del corazón que permiten identificar cambios estructurales y funcionales, como alteraciones en las presiones, cambios de flujo, fracción de expulsión del ventrículo izquierdo y remodelación anatómica de las superficies miocárdicas.

Métodos diagnósticos cardiovasculares en pacientes con diabetes mellitus. Revisión / Cardiovascular diagnostic methods in patients with diabetes mellitus. A review

Resumen Las enfermedades cardiovasculares constituyen la causa más común de mortalidad en el mundo. Actualmente, la diabetes mellitus tipo 2 (DM2) representa uno de los principales factores de riesgo de eventos adversos cardiovasculares mayores. Los pacientes que las padecen tienen un riesgo cuatro veces mayor de desarrollar insuficiencia cardíaca y una mortalidad de 10 a 12 veces mayor. La ecocardiografía en todas sus modalidades es la mejor herramienta clínica para el diagnóstico de la insuficiencia cardíaca, ya que proporciona imágenes estáticas y dinámicas del corazón que permiten identificar cambios estructurales y funcionales, como alteraciones en las presiones, cambios de flujo, fracción de expulsión del ventrículo izquierdo y remodelación anatómica de las superficies miocárdicas.

Abstract Cardiovascular diseases are the most common cause of mortality in the world. Currently, type 2 diabetes mellitus (T2DM) is one of the main risk factors for major adverse cardiovascular events. T2DM patients have a four-fold higher risk of developing heart failure and 10 to 12 times higher mortality. Echocardiography in all its modalities is the best clinical tool for heart failure diagnosis, since it provides static and dynamic images of the heart that allow to identify structural and functional changes, such as pressure variations, flow changes, left ventricular ejection fraction and myocardial surfaces anatomical remodeling.

How to Restart the Interventional Activity in the COVID-19 Era: The Experience of a Private Pain Unit in Spain.

INTRODUCTION: The situation generated in the health system by the COVID-19 pandemic has provoked a crisis involving the necessity to cancel non-urgent and oncologic activity in the operating room and in day-to-day practice. As the situation continues, the need to reinstate attention for patients with chronic pain grows. The restoration of this activity has to begin with on-site appointments and possible surgical procedures. On-site clinical activity has to guarantee the safety of patients and health workers. OBJECTIVES: The objective of this review was to evaluate how to manage activity in pain units, considering the scenario generated by the pandemic and the implications of chronic pain on the immune system and proposed pharmacological and interventional therapies. METHODS: Besides the established general recommendations (physical distance, surgical masks, gloves, etc.), we established specific recommendations that will allow patient treatment and relieve the disruption of the immune response. It is important to highlight the use of opioids with the least influence in the immune system. Further, individualized corticoid use, risk assessment, reduced immune suppression, and dose adjustment should take patient needs into account. In this scenario, we highlight the use of radiofrequency and neuromodulation therapies, techniques that do not interfere with the immune response. CONCLUSIONS: We describe procedures to implement these recommendations for individual clinical situations, the therapeutic possibilities and safety guidelines for each center, and government recommendations during the COVID-19 pandemic.

Indicadores del Programa Materno Infantil en Bartolomé Masó Márquez durante los años 2016-2017 / Indicators of the Maternal and Child Program in Bartolomé Masó Márquez during the years 2016-2017 / Indicadores do Programa Materno-Infantil de Bartolomé Masó Márquez durante os anos de 2016-2017

RESUMEN La tasa de mortalidad infantil es el indicador que corresponde al número de fallecidos dentro del primer año de vida referidos a 1 000 nacidos vivos durante el mismo período; el lapso utilizado para la determinación de las tasas, por lo general, es de un año. Con el objetivo de determinar el comportamiento de algunos indicadores del Programa Materno Infantil durante 2016-2017. Se realizó un estudio observacional descriptivo. El universo comprendió todos los nacimientos en Bartolomé Masó Márquez en el período de estudio, las muertes maternas, las muertes fetales y la población menor de cinco años. Se utilizaron las siguientes variables: fallecido menor de un año, causas del fallecimiento, dirección, muertes maternas, bajo peso al nacer, mortalidad fetal tardía, fallecidos menores de cinco años. Se logra una a tasa de mortalidad infantil de 3,74 por cada 1 000 nacidos vivos, La tasa de mortalidad preescolar se mantiene de 3,9 por 10 000 habitantes de la edad. Se incrementa la tasa de mortalidad del menor de cinco años de 4,9 a 5,6 por cada mil nacidos vivos. La tasa de mortalidad escolar se reduce de 3,1 a 1,6 por 10 000 habitantes de la edad. Se incrementa una tasa de mortalidad fetal de 6.57 a 11,2 por cada 1 000 nacidos vivos. No ocurren muertes maternas directas. Se reduce el índice de bajo peso al nacer de 5,59 a 4,6 por cada 100. En el municipio el programa materno infantil muestra resultados favorables en los indicadores analizados, lo que se corresponde con los de países del primer mundo.

ABSTRACT The infant mortality rate is the indicator that corresponds to the number of deaths within the first year of life referred to 1,000 live births during the same period; the period used to determine the rates is generally one year. In order to determine the behavior of some indicators of the Maternal and Child Program during 2016-2017. A descriptive observational study was performed. The universe included all births to Bartolomé Masó Márquez in the study period, maternal deaths, fetal deaths, and the population under the age of five. The following variables were used: deceased less than one year, causes of death, address, maternal deaths, low birth weight, late fetal mortality, deceased under five years. An infant mortality rate of 3.74 is achieved for every 1,000 live births. The preschool mortality rate remains at 3.9 per 10,000 inhabitants of age. The under-five mortality rate increases from 4.9 to 5.6 for every thousand live births. The school mortality rate is reduced from 3.1 to 1.6 per 10,000 inhabitants of age. A fetal mortality rate increases from 6.57 to 11.2 for every 1,000 live births. Direct maternal deaths do not occur. The low birth weight index is reduced from 5.59 to 4.6 per 100. In the municipality, the maternal and child program shows favorable results in the analyzed indicators, which corresponds to those of first world countries.

RESUMO A taxa de mortalidade infantil é o indicador que corresponde ao número de óbitos no primeiro ano de vida referentes a 1.000 nascidos vivos no mesmo período; o período usado para determinar as taxas é geralmente de um ano. Para determinar o comportamento de alguns indicadores do Programa Materno-Infantil durante o período de 2016-2017. Foi realizado um estudo observacional descritivo. O universo incluiu todos os nascimentos de Bartolomé Masó Márquez no período do estudo, óbitos maternos, óbitos fetais e população com menos de cinco anos. Foram utilizadas as seguintes variáveis: falecido há menos de um ano, causas de morte, endereço, óbitos maternos, baixo peso ao nascer, mortalidade fetal tardia, falecido com menos de cinco anos. É alcançada uma taxa de mortalidade infantil de 3,74 para cada 1.000 nascidos vivos, e a taxa de mortalidade pré-escolar permanece em 3,9 por 10.000 habitantes. A taxa de mortalidade de menores de cinco anos aumenta de 4,9 para 5,6 para cada mil nascidos vivos. A taxa de mortalidade escolar é reduzida de 3,1 para 1,6 por 10.000 habitantes. A taxa de mortalidade fetal aumenta de 6,57 para 11,2 para cada 1.000 nascidos vivos. As mortes maternas diretas não ocorrem. O índice de baixo peso ao nascer é reduzido de 5,59 para 4,6 por 100. No município, o programa materno-infantil mostra resultados favoráveis ​​nos indicadores analisados, que correspondem aos dos países do primeiro mundo.

Exploring Tiny Homes as an Affordable Housing Strategy to Ameliorate Homelessness: A Case Study of the Dwellings in Tallahassee, FL.

An emerging strategy to combat homelessness is the development of "tiny homes". However, the advent of tiny homes as a new form of housing intervention raises a number of questions about their intentions, efficacy, and policy feasibility. This paper seeks to understand the strategies used by stakeholders to plan, design, and implement a tiny home community to meet the needs of those experiencing homelessness, and to understand where these plans were effective and where challenges arose in meeting the intended project goals. Utilizing the recent development of Tallahassee's "The Dwellings" project as a case study, we examine how the community was planned, resident experiences, and constraints to implementing a tiny home development. We use qualitative methods that include interviews with stakeholders who were integral to the planning and development process. Our findings highlight how funding constraints and NIMBYism (Not in My Backyard-ism) stymied stakeholder efforts to achieve equity and affordability at The Dwellings, resulting in the inability to achieve project aims of developing housing that serves the homeless population. We conclude by offering some observations and lessons learned for future research on tiny homes as a solution to ameliorate homelessness.