The microbiology of sepsis is more than the application of new technologies in diagnosis.

Adequate and rapid microbiological diagnosis of sepsis is essential for correct treatment, having a direct impact on patient prognosis. Clinical Microbiology Services must adapt fast circuits that allow prioritizing and individualizing the diagnosis of these patients. The measures adopted should not be based solely on the incorporation of new technologies but, to a large extent, on ensuring accurately collection and processing of samples, avoiding unnecessary losses of time in processing and ensuring that the information derived from this process adequately reaches the prescribing physician.

Proceso de Atención de Enfermería a una lactante con neumonía basado en patrones funcionales de Marjory Gordon / Nursing Care Process on an infant suffering from pneumonia based on the Marjory Gordon Functional Patterns

El Proceso de Atención de Enfermería (PAE) que se presenta tiene como objetivo: Identificarlas necesidades alteradas, corregir, mantener y rehabilitar al paciente por medio de la aplicación de conocimientos y procedimientos, con la finalidad de que este recobre en el menor tiempo posible su salud, en este caso una lactante con neumonía. Hoy en día, la neumonía es la causa principal de muerte de niños menores de 5 años en todo el mundo, su principal afectación son los alvéolos pulmonares, lo que compromete el patrón respiratorio. Esta enfermedad si no es tratada oportunamente puede tener complicaciones como: fallo respiratorio agudo, absceso pulmonar, insuficiencia cardiaca congestiva. Es entonces cuando el personal de Enfermería juega un papel importante en la ejecución de intervenciones, que ayuden a mantener la permeabilidad y la estabilidad de la vía aérea. Se identificaron las necesidades prioritarias con base en los 11 patrones funcionales de Marjory Gordon; se diseñó un plan de cuidados individualizado encaminado al mantenimiento del patrón respiratorio, para este se utilizaron las taxonomías: NANDA, NIC y NOC. Los resultados obtenidos fueron satisfactorios, se logró disminución de la dificultad respiratoria, mejoría en la permeabilidad de la vía aérea, mantenimiento de la frecuencia cardiaca y prolongación de periodos de sueño; sin embargo debido a que la paciente presentaba una desnutrición severa con evolución de 6 meses, no pudo modificarse ese patrón y aunado a la gravedad del padecimiento falleció.

The Nursing Attention Process (NAP) aims to identify altered needs, and correct, maintain and rehabilitate the patient through the use of knowledge and procedures, so that he/she can be healthy as soon as possible. In this study, the patient was an infant suffering from pneumonia. Currently, pneumonia is the world's principal cause of death in children younger than 5 years old. Indeed, consequences of not treating this illness on time include acute respiratory arrest, lung abscesses, and congestive cardiac insufficiency. Here, is when the nursing staff has a crucial role at maintaining the permeability and stability of the respiratory airways of these patients. Priority needs were identified through the 11 functional pattern of Marjory Gordon. An individualized care plan was designed and aimed to the maintenance of the child's respiratory patterns. NANDA, NIC and NOC taxonomies were used. Satisfactory results included a decrease in the respiratory difficulty, an improvement in the airway permeability, the maintenance of the cardiac rate, and the improvement of sleep time. However, due to a 6 month previous malnutrition, and the complications of this illness, unfortunately this patient died.

Molecular assembly of multi-wall carbon nanotubes with amino crown ether: synthesis and characterization.

Synthetic methodology and physicochemical characterization of multi-wall carbon nanotubes (MWCNTs) functionalized with a crown ether molecule is reported. The MWCNTs were synthesized by spray pyrolysis technique using toluene as carbon source and ferrocene as catalyst. The nanotubes were characterized by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Oxidation of MWCNTs was carried out by 8 h of sonication in a mixture of sulfuric and nitric acid (3:1). The MWCNT-COOH was amidated with 4-aminobenzo-15-crown-5 under mild reaction conditions using N,N'-dicyclohexylcarbodiimide and dimethylaminopyridine as catalyst and dimethylformamide as solvent, at room temperature for 24 h. The amidation product was characterized by scanning electron microscopy, infrared spectroscopy, X-ray photoelectron spectroscopy, atomic force microscopy and a mass spectrometry study to determine the fragmentation pattern being m/z 309, 177 and 149 the most important ions.

[Nocturnal drop of arterial blood pressure: determinant factors and relationship with organic damage secondary to hypertension]. / Descenso nocturno de la presión arterial: factores determinantes y relación con daño orgánico secundario a hipertensión.

OBJECTIVES: To evaluate the night-time drop in blood pressure in patients with light hypertension and to determine its possible relationship with damage in key organs. DESIGN: Cross-sectional study. SETTING: Eight urban health centres. PATIENTS: Four hundred and eighteen adults with light-moderate hypertension. INTERVENTIONS: a) Blood pressure reading on three visits; b) ambulatory monitoring of pressure for 24 hours; c) echocardiograph (in 219 patients); d) albuminuria determination (in 134 patients). A night-time drop in blood pressure was defined as the difference between day and night ambulatory pressures; and relative drop, as the night-time pressure drop as a percentage of the day-time pressure. RESULTS: Night-time drop in systolic and diastolic pressures was 13.6 (10.7) and 12.1 (8.6) mmHg, respectively. The predictive factors of night-time drop in blood pressure were, directly, daily ambulatory blood pressure (p < 0.05) and female gender (p < 0.05) and, inversely, age (p < 0.05). No association was observed between night-time drop in blood pressure and left ventricular mass. Only in women was an independent relationship found, inversely, between night-time drop in blood pressure and urinary excretion of albumin (p < 0.05). CONCLUSIONS: Relative night-time drop in blood pressure is greater in women than in men, diminishes with age and depends on the day-time ambulatory pressure. In women a minor night-time drop in blood pressure is associated with greater organic damage.

Bronchocentric granulomatosis associated with pure red cell aplasia and lymphadenopathy.

Bronchocentric granulomatosis developed in a patient with previously diagnosed pure red cell aplasia and lymphadenopathy. There was an excellent response to corticosteroid treatment. An immunological pathogenesis common to bronchocentric granulomatosis and pure red cell aplasia is suggested.

Esophageal candidiasis associated with acute infection due to human immunodeficiency virus: case report and review.

Esophageal candidiasis, an opportunistic infection that generally occurs in the latest phases of infection due to the human immunodeficiency virus (HIV), is currently a diagnostic criterion for acquired immunodeficiency syndrome (AIDS). We recently treated one patient for esophageal candidiasis associated not with AIDS but with acute HIV infection. At follow-up 19 months later, he was well and had no symptoms related to infection with HIV. We reviewed nine previously reported cases of esophageal candidiasis associated with acute HIV infection. None of the patients involved had other predisposing illnesses or risk factors for candidiasis. The case described herein, together with those reviewed, supports a revision of the Centers for Disease Control's clinical definition of primary HIV infection to include esophageal candidiasis in the clinical spectrum. Moreover, the value of esophageal candidiasis as a diagnostic criterion for AIDS should be reassessed.

Pulmonary alveolar proteinosis: prolonged spontaneous remission in two patients.

Pulmonary alveolar proteinosis is a rare idiopathic diffuse airspace disease characterized by intra-alveolar accumulation of large quantities of lipoproteinaceous material, with preservation of the lung interstitium. The clinical course of pulmonary alveolar proteinosis is variable. Spontaneous resolution is known to occur in up to a quarter of the cases. We describe two patients with untreated pulmonary alveolar proteinosis who experienced complete clinical, functional and radiographic resolution. In follow-up periods of fourteen and six years, both patients have remained asymptomatic.