A Comprehensive Review of Sulfonamide Hypersensitivity: Implications for Clinical Practice.

Sulfonamides, which are drugs commonly prescribed in hospital and outpatient settings, have historically been associated with a high incidence of hypersensitivity reactions. It is believed that there is an increased risk of cross-reactions with other drugs that contain this functional group in their structure. However, it has not been conclusively established that the sulfonamide group is the sole cause of hypersensitivity reactions, as non-antibiotic sulfonamides do not share the same accessory groups with antibiotic sulfonamides. Therefore, cross-reactivity between different types of sulfonamides and sulfonamide-type antibiotics is not clearly demonstrated, and allergic reactions may involve other mechanisms. Misinformation about this topic can lead to inappropriate use of alternative antibiotics with lower efficacy or higher adverse effects, contributing to antibiotic resistance. It is crucial to individualize and monitor patients with a history of allergies to sulfonamide-type antibiotics when introducing a new drug containing sulfa and manage any adverse reactions promptly. Desensitization protocols may be a viable option for patients who specifically benefit from these antibiotics, particularly those who are immunosuppressed. This article provides a descriptive bibliographic review to update information on sulfa allergy, its prevalence, management, and recommendations to prevent such reactions and optimize pharmacotherapy, without underusing these drugs.

The Water-Soluble Chitosan Derivative, N-Methylene Phosphonic Chitosan, Is an Effective Fungicide against the Phytopathogen Fusarium eumartii.

Chitosan has been considered an environmental-friendly polymer. However, its use in agriculture has not been extended yet due to its relatively low solubility in water. N-Methylene phosphonic chitosan (NMPC) is a water-soluble derivative prepared by adding a phosphonic group to chitosan. This study demonstrates that NMPC has a fungicidal effect on the phytopathogenic fungus Fusarium solani f. sp. eumartii (F. eumartii) judged by the inhibition of F. eumartti mycelial growth and spore germination. NMPC affected fungal membrane permeability, reactive oxygen species production, and cell death. Also, this chitosan-derivative exerted antifungal effects against two other phytopathogens, Botrytis cinerea, and Phytophthora infestans. NMPC did not affect tomato cell viability at the same doses applied to these phytopathogens to exert fungicide action. In addition to water solubility, the selective biological cytotoxicity of NMPC adds value in its application as an antimicrobial agent in agriculture.

Synthesis, characterization and evaluation of reactional parameters on substitution degree of N-hexyl-N-methylene phosphonic chitosan.

N-methylene phosphonic chitosan (NMPC) is treated with hexyl aldehyde to give an imine, which is easily converted into N-hexyl-N-methylene phosphonic chitosan (HNMPC) under mild conditions. The structure of this new chitosan derivative is characterized by FT- IR, 1H, 13C, 31P, 1H13C-HSQC NMR, SEM and XRD. The influence of reactional parameters on the substitution degree (DS), evidenced that a mol ratio 1.50:1.00 (hexyl aldehyde: free amino groups); a reaction time of 1 h. and 45 °C of temperature afford the best DS. HNMPC molecular weight is 12,768.62 Da. It shows good emulsifying properties giving o/w emulsions with high stability in time. Microscopic observation as well as particle size distribution show an unimodal droplet size distribution with low droplet diameters. Preliminary tests lead us to believe that this new polymer has good film forming properties.

Cirugía bariátrica: generalidades / Bariatric surgery: general

La obesidad es considerada una epidemia en la actualidad. Es definida por la OMS como un índice de masa corporal (IMC) mayor o igual a 30. Se han realizado numerosos esfuerzos para determinar distintos tratamientos que permitan disminuir tanto la prevalencia de dicha enfermedad como las complicaciones asociadas a la misma.La cirugía bariátrica marca el inicio de una nueva era, en la que es posible reducir la morbi-mortalidad asociada a la obesidad. Específicamente se ha demostrado remisión en algunos casos de diabetes, tendencia a la mejoría en pacientes con NAFLD, NASH y reflujo gastroesofágico, así como franca mejoría a nivel cardiovascular. El propósito principal de este artículo es discutir el impacto de la cirugía bariátrica sobre dichas comorbilidades y sobre mortalidad, además las técnicas quirúrgicas, complicaciones y criterios de selección, con el fin de definir cuáles pacientes se benefician de este abordaje.

Obesity is defined as a body mass index greater or equal to 30, nowadays it is considered an epidemic. Numerous efforts have been carried on in order to define treatments that will effectively reduce the prevalence and complications of this condition. Bariatric surgery came to mark the beginning to a new era in this field; it demonstrated a reduction in morbi-mortality in patients with obesity. It has proven to induce remission in patients with diabetes, to improve NAFLD, NASH and GERD, and to be associated to a definite cardiovascular benefit. The main purpose of this article is to discuss the impact that bariatric surgery has over these comorbidities as well as on mortality. Surgical techniques, complications, and selection criteria are also addressed with the objective of defining which patients will benefit from this intervention.

Physico-chemical studies and emulsifying properties of N-propyl-N-methylene phosphonic chitosan.

Chitosan is a modified, natural carbohydrate polymer derived by deacetylation of chitin. Due to the presence of two functional groups can undergo many chemical modifications. In a previous work we described the synthetic strategy and characterization of a novel soluble derivative: N-propyl-N-methylene phosphonic chitosan (PNMPC). In the study of some physicochemical properties, results showed that this modified chitosan aggregates in several steps when the concentration is increased. By addition of NaOH the initially coiled molecules stretch exposing more phosphonic acid groups to neutralization and finally give a cooperative reaction with OH((). PNMPC has emulsifying properties and gives O/W emulsions with quasi-monodisperse small droplets. Emulsions with 0.18% PNMPC and 30:70 o:w ratio exhibited the best emulsifying properties within the test range. This emulsion ratio showed high stability to long time storage and several successive freeze/thaw and heating/cooling cycles.

"I wouldn't look at it as stress": conceptualizations of caregiver stress among low-income families of children with asthma.

Low-income caregivers of children with asthma experience multiple stressors, likely worsening family health. As part of Community Action Against Asthma's community-based participatory research partnership, researchers conducted 40 qualitative semi-structured interviews and quantitative surveys with low-income caregivers of children with asthma in Detroit, Michigan. Participants described daily childhood asthma experiences and completed scales including the Peds Quality of Life Family Impact Module and Zarit Burden Caregiver Scale. Quantitative scale findings suggested participants are moderately stressed or affected by their child's illness. While there was some accordance between qualitative and quantitative findings, qualitative findings additionally captured many relevant life stressors, seemingly overlooked or conflated in scale responses. Many participants described asthma as part of childrearing, rather than as a stressor or burden. Findings encourage improvement of clinical, psychometric assessments used to measure and address stressors that shape health for many families with children with asthma.

A life course perspective on stress and health among caregivers of children with asthma in Detroit.

Low-income caregivers raising children with asthma experience many obstacles to their own health, including stress. To understand and describe their daily experiences, researchers conducted 40 qualitative interviews supplemented with descriptive quantitative surveys in Detroit, Michigan, as part of a community-based participatory research partnership of Community Action Against Asthma. Prevalence of chronic illness is noticeably higher among participants than the general US population. Caregivers identified stress processes that may influence disproportionate health outcomes and risk-related behaviors over their lifetime. Applying a life course perspective, findings suggest that public health interventions should address family-level comorbidities, increase instrumental social support, and acknowledge practical coping mechanisms.