Contribution of halloysite as nanotubular clay mineral on mechanism and adsorption rate of Cd(II) onto nanocomposites alginate-halloysite.

In this work nanocomposites based on alginate (Alg) and halloysite as a nanotubular clay (Hy) were developed. Characterization techniques reveal that Hy/Alg nanocomposites are cation exchangers with predominantly negative charge density and good thermal stability. The adsorption equilibrium of Cd(II) in aqueous solution onto Hy/Alg nanocomposites revealed that by increasing the mass of halloysite in the nanocomposite, the adsorption capacity diminished significantly due to the halloysite-alginate interactions. Maximum adsorption capacities of 8, 65, 88, and 132 mg/g of Cd(II) were obtained for samples Hy, Hy/Alg 50%, Hy/Alg 95%, and Alg, respectively. In addition, the adsorption equilibrium of Cd(II) on the Hy/Alg bionanocomposites was affected by the pH and temperature of the solution, demonstrating the presence of electrostatic interactions during adsorption and that this is an exothermic process. The controlling mechanism of adsorption was cation exchange influenced by electrostatic forces. The Cd(II) adsorption rate studies were interpreted by the diffusion-permeation model and reveal that the presence of Hy in the structure of the nanocomposites enhances the permeation coefficient, that is, the adsorption rate was increased. The values of the permeation coefficient varied from 1.95 × 10-7 to 8.50 × 10-7 cm2/s for Hy/Alg 50% and from 1.70 × 10-7 to 3.55 × 10-7 cm2/s for Hy/Alg 95%.

Skewed Invariant Natural Killer T (iNKT) Cells, Impaired iNKT:B Cell Help and Decreased SAP Expression in Blood Lymphocytes from Patients with Common Variable Immunodeficiency.

Common variable immunodeficiency (CVID) is a syndrome with predominantly defective B cell function. However, abnormalities in the number and function of other lymphocyte subpopulations in peripheral blood (PB) have been described in most patients. We have analysed the distribution of iNKT cell subpopulations in the PB of CVID patients and the ability of these cells to provide in vitro cognate B cell help. The total of iNKT cells was reduced in the PB of CVID patients, especially CD4+, CD4-/CD8- and CCR5+/CXCR3+. These findings were associated with an enrichment of memory-like and a tendency towards a reduction in TNF-α-expressing effector iNKT cells in the peripheral blood mononuclear cells (PBMC) of CVID patients. Moreover, an accumulation of follicular helper iNKT cells in the PB of CVID patients was demonstrated. CVID αGalCer-pulsed iNKT cells are not able to induce autologous B cell proliferation although they do induce proliferation to healthy donor B cells. Interestingly, autologous and heterologous co-cultures did not differ in the amount of immunoglobulin secreted by B cells in vitro. Finally, reduced intracellular SAP expression in iNKT cells and other lymphocytes in the blood from CVID patients was observed. These results provide further insights into the immunological mechanisms underlying the iNKT cell defects and the potential targets to improve B cell help in CVID.

Application of the diagnostic criteria for Common Variable Immunodeficiency in resource-limited settings

Introduction: Common variable immunodeficiency (CVID) is the most prevalent symptom-atic humoral deficiency; however, its heterogeneous presentation makes the diagnosis diffi-cult. The present study is aimed to verify the CVID diagnostic criteria as established by the European Society for Immunodeficiencies in 42 CVID patients from our outpatient clinic. Methods: Information was collected from their medical records and when needed, lymphocyte subpopulations in peripheral blood (PB) were performed by flow cytometry. Results: All the patients fulfilled the clinical working definition for CVID and showed decreased serum IgG and IgA at diagnosis. Over two-thirds of the patients had decreased memory B cell percentages. However, the remaining patients exhibited other quantitative B cell defects in PB. Evaluation of vaccination responses was only found in 13 records and 69% were not respon-sive. None of the patients were subjected to vaccination studies to both, T-cell dependent and independent antigens. The two required tests to evaluate T cell responses were performed in 84.2% of the patients and reported normal. Without the support of third-party payers, only 34.2% of our patients would have completed the required evaluations. Conclusions: Further efforts are needed to speed up CVID diagnosis in low-resourced settings, increasing the availability of the required resources and optimizing the healthcare supply chain (AU)

Fluconazole response patterns in HIV-infected patients with oropharyngeal candidiasis.

A prospective study to assess the efficacy of fluconazole in oropharyngeal candidiasis in patients with HIV was conducted. A cohort of 30 HIV-positive persons with clinical and microbiologic confirmed oropharyngeal candidiasis (Candida albicans > 1000 CFU/ml) received fluconazole 100 mg daily for 7 days. In vitro antifungal susceptibility tests demonstrated a lack of fluconazole resistances. Cultures of mouth swabs were performed at the end of therapy and 2 weeks later. There was a clinical and microbiologic cure in 26 patients (87%). In 10 of these 26, cultures remained negative after 2 weeks; most of them had CD4 lymphocyte count > 400/ml. In the other 16 patients (53%), cultures showed a microbiologic relapse 2 weeks after treatment. In spite of clinical improvement, treatment failure was observed in four patients, all of them with CD4 lymphocyte count < 50 ml.

[Infantile dyspnea due to pyogenic laryngeal granuloma]. / Disnea infantil por "granuloma piogénico" laríngeo.

Two appearances are outstanding in this case report. First is the clinical picture of chronic laryngeal stridor of a child due to an acquired haemangioma. And that the anatomopathologic subtype of angioma is a pyogenic granuloma noteworthy, as we shall see, the use of the term "pyogenic granuloma" based only on anatomopathological findings in order to circumscribe this lesion.

[Breast feeding and length of hospitalization]. / Lactancia y estancia hospitalaria.

One of the important tasks for a nurse is to insure that the newborn receives all the nourishment that it needs. A well fed baby is healthier, experiences a shorter hospital stay and develops a stronger bond with its mother. To prove this point a study was performed on a group of low birth weight newborns (free of other pathological symptoms) to compare nutrition against hospitalization time. 85 children of both sexes were divided into 3 groups: premature but of normal gestational size, premature but small for gestational size, and full term but small for gestational size; all had a birth weight superior to 2 kilos and were examined postpartum on their first and third week. The groups were then subdivided into 2 groups: one received only artificial milk formula and the other group received their mothers' milk through a bottle. The children that drank the maternal milk required fewer days in the hospital (18 +/- 6 days versus 27 +/- 7 days for those drinking only formula) and had a smaller percentage of weight loss after birth (3.7 +/- 2.0% versus 5.2 +/- 2.9%), demonstrating a significant difference in their overall health.

Functional consequences of partial glossectomy.

The postsurgical deglutition, oral suction, and speech capabilities of 11 patients who had undergone partial glossectomy for squamous cell carcinoma of the lateral aspect of the tongue were compared with that of 20 healthy control subjects. Volume swallowed per second and speech quality were significantly correlated with the area of tongue removed. Three patients subjected to a second operation to improve the mobility of the residual tongue regained almost normal speech intelligibility. In general, functional performance was better than expected, which justifies a radical surgical approach to this kind of tumor.

[Multifocal renal carcinoma]. / Multifocalidad del carcinoma renal.

OBJECTIVES: To analyze the incidence of multifocality in renal carcinoma. METHODS: A retrospective study was conducted to determine the incidence of multifocality in renal carcinoma. We analyzed 50 surgical specimens from patients with renal carcinoma who had undergone radical nephrectomy at our institution between September, 1992 and December, 1994. RESULTS: 9 of the 50 specimens (18%) had more than one lesion in the same kidney. CONCLUSIONS: The incidence of multifocality in renal carcinoma has been reported to range from 6% to 30%, which implies that if conservative surgery is performed, the likelihood of tumor recurrence is not negligible. We believe therefore that radical surgery must be performed, except in those cases where conservative surgery is mandatory (solitary kidney, bilateral tumors).

[Treatment of ureteral lithiasis with lithoclast: analysis of our experience]. / Tratamiento de la litiasis ureteral con lithoclast: análisis de nuestra experiencia.

OBJECTIVES: To analyze the role and the results achieved with the Lithoclast in the treatment of distal ureteral calculi in the era of ESWL. METHODS: From March, 1994 to April, 1995, 41 patients with ureteral calculi were treated by ureteroscopy and direct stone fragmentation with the Lithoclast. RESULTS: 90% of the patients were stone-free one month after treatment; 3 patients in whom stone fragmentation could not be achieved required ESWL; one patient required open surgery for ureteral detachment. CONCLUSIONS: Ureteroscopy and stone fragmentation with the Lithoclast is a good, inexpensive mode of treatment of ureteral stones and is particularly indicated as the first mode of treatment in those centers, like ours, where ESWL is unavailable.