Ultrasonically spray coated silver layers from designed precursor inks for flexible electronics.

Integration of electronic circuit components onto flexible materials such as plastic foils, paper and textiles is a key challenge for the development of future smart applications. Therefore, conductive metal features need to be deposited on temperature sensitive substrates in a fast and straightforward way. The feasibility of these emerging (nano-) electronic technologies depends on the availability of well-designed deposition techniques and on novel functional metal inks. As ultrasonic spray coating (USSC) is one of the most promising techniques to meet the above requirements, innovative metal organic decomposition (MOD) inks are designed to deposit silver features on plastic foils. Various amine ligands were screened and their influence on the ink stability and the characteristics of the resulting metal depositions were evaluated to determine the optimal formulation. Eventually, silver layers with excellent performance in terms of conductivity (15% bulk silver conductivity), stability, morphology and adhesion could be obtained, while operating in a very low temperature window of 70 °C-120 °C. Moreover, the optimal deposition conditions were determined via an in-depth analysis of the ultrasonically sprayed silver layers. Applying these tailored MOD inks, the USSC technique enabled smooth, semi-transparent silver layers with a tunable thickness on large areas without time-consuming additional sintering steps after deposition. Therefore, this novel combination of nanoparticle-free Ag-inks and the USSC process holds promise for high throughput deposition of highly conductive silver features on heat sensitive substrates and even 3D objects.

[Is morphine still the analgesic of choice in acute myocardial infarction?]. / Sigue siendo la morfina el analgésico de elección en el infarto agudo de miocardio?

Chest pain is the most common symptom of patients who present with ischemic heart disease. Morphine has traditionally been the drug of choice for managing chest pain in acute coronary syndrome (ACS) due to its high analgesic potency, though its physiological effects are poorly understood. Routinely used for managing chest pain, morphine is recommended in the 2002 guidelines of the American College of Cardiology/American Heart Association. This recommendation, however, is not based on a high level of scientific evidence but on expert opinion. Studies have found both for and against the use of morphine in ACS, suggesting that its benefits are perhaps not altogether clear. This review examines the pathophysiological effects of morphine and their cardiac implications, with special attention to a possible negative effect on ACS. We reviewed articles in the MEDLINE database from 1982 to 2006.

Metastatic melanoma of unknown primary tumor.

The appearance of metastasis without clinically demonstrable primary tumor is one of melanoma's challenges. The aim of this study was to recognize the specific characteristics of this occurrence. Based on our study of three patients, we have proposed theories to explain this behavior, its clinical approach, and therapeutic management. We conclude by stressing the importance of finding the primary tumor or traces of it.

[Marfan's syndrome]. / Síndrome Marfan.

We report our experience in the diagnosis, evaluation and counseling for the Marfan Syndrome in 35 individuals of 23 families. Utilizing the new clinical and diagnostic criteria, we observed that the frequency of the systems affected corresponds to those found in the literature. Presymptomatic treatment is possible, and considering the family history in the diagnosis is needed for adequate genetic counseling and the well-being of the affected patient.

Distichiasis-lymphedema syndrome and the Turner phenotype.

Two unrelated females with the syndrome of distichiasis-lymphedema are presented. In both families, the autosomal dominant nature of the syndrome was evident, with multiple affected males and females. In the prepubertal period this disease may be confused with Turner or Noonan syndromes. Genetic counseling is important for this is a very crippling disease and an erroneous diagnosis of future sterility may be given to affected females. Ptosis, pterygium colli, lymphedema, cleft palate and a low posterior hairline can confuse the phenotype. A history of corneal irritation, photophobia and a need to self-pluck eyelashes may be the clue to the diagnosis. Close follow-up for associated complications, counseling and support to these families may be our contributions as clinicians in ameliorating the burden this disease brings.

Rett syndrome. The Puerto Rican experience.

We have diagnosed and followed four Puerto Rican females with Rett Syndrome (RS). Their ages, when first examined, ranged from 10 months to 11 years. The classical symptoms of decreasing head size, onset of hand wringing movements with deterioration of milestones as well as EEG abnormalities were present in all. Case No. 1, considered our index case was evaluated by us and lost to follow-up for many years while residing in the mainland U.S.A. where multiple evaluations failed to give a definite diagnosis. Upon her return to Puerto Rico she was diagnosed by us in retrospect as having RS. These are the first Puerto Rican girls reported with RS and in doing so we hope for a better understanding of the syndrome by our medical community. Because of the devastating effects of RS, early diagnosis and parental counseling will be beneficial for patients and their families.

Mucinosis of the mammary areolae and mycosis fungoides.

We present a patient with cutaneous mucinosis of the mammary areolae who developed multiple erythematous macules with clearly defined, geographical edges 1 year after diagnosis. These lesions demonstrated mycosis fungoides on histology. We discuss a possible association between the mucinosis and the mycosis fungoides.

Transfusion-associated acute graft-versus-host disease in a heart transplant recipient.

We report a heart transplant recipient who developed graft-versus-host disease (GVHD) following blood transfusion. We consider that heart transplant recipients should be included in the category of immunosuppressed patients who may develop this disease after being treated with blood products. We also consider that, at the present time, irradiation of blood products is the only useful method of avoiding development of GVHD in these patients.

Quinacrine fluorescence and Giemsa banding in trisomy 22.

Using quinacrine fluorescence and Giemsa banding techniques we have identified an extra chromosome 22 in three non-mongoloid children with similar phenotypes and 47 chromosomes. In one of the children, the long arm of the extra 22 was shorter than usual. This 22q-chrcmcscme was observed in 4 normal family members with 46 chromosomes. In a fourth child, with similar physical findings, the extra G chromosome was shown to be neither a normal 21 nor 22. It must have arisen from a rearrangement in a parental gamete since it was not present in either parent's karyotype.No constellation of clinical findings, in association with an extra G chromosome, is sufficient evidence for the diagnosis of trisomy 22. The positive identification of the extra chromosome must be made using fluorescence and banding.

Focal dermal hypoplasia symdrome in a male.

Focal dermal hypoplasia (Goltz syndrome) is characterized by a pathognomonic abnormality of the skin in association with other congenital defects. There are only seven males among the 52 reported cases. We report the eighth case in a male and evaluate the possible genetic origin of the syndrome. A critical review of the literature provides no evidence for the previously accepted single gene mode of inheritance.