Scalable Production of Ambient Stable Hybrid Bismuth-Based Materials: AACVD of Phenethylammonium Bismuth Iodide Films*.

Large homogeneous and adherent coatings of phenethylammonium bismuth iodide were produced using the cost-effective and scalable aerosol-assisted chemical vapor deposition (AACVD) methodology. The film morphology was found to depend on the deposition conditions and substrates, resulting in different optical properties to those reported from their spin-coated counterparts. Optoelectronic characterization revealed band bending effects occurring between the hybrid material and semiconducting substrates (TiO2 and FTO) due to heterojunction formation, and the optical bandgap of the hybrid material was calculated from UV-visible and PL spectrometry to be 2.05 eV. Maximum values for hydrophobicity and crystallographic preferential orientation were observed for films deposited on FTO/glass substrates, closely followed by values from films deposited on TiO2 /glass substrates.

Assessment of the characterization of nonabsorbing nanoparticles in suspension from effective optical properties.

We analyze a method recently proposed to retrieve the size, refractive index, and concentration of particles in nonabsorbing nanofluids from measurements of the complex effective refractive index of two dilutions of the nanofluid [Opt. Lett.39, 559 (2014)]. The method uses simple formulas to retrieve the particles' parameters. First, we discuss precautions needed with the new method when inferring the refractive index of the particles from measurements of the imaginary part of the effective refractive index of two dilutions of the original nanofluid. Then we analyze the use of this methodology to obtain some average radius in the size of polydisperse suspensions and in the case of suspensions of weakly absorbing particles. We also perform an error analysis considering fixed errors in measurements and calculating the errors in the retrieved size, refractive index, and concentration of particles. Finally, we characterize experimentally nanofluids of polymeric particles fabricated of poly(methyl-methacrylate) (PMMA) and polystyrene (PS) for which we achieved an uncertainty of 5×10(-3) and 1×10(-2) in the determination of the particle refractive index, respectively, and a precision better than 3% in the determination of their radii.

Forum for debate: Safety of allogeneic blood transfusion alternatives in the surgical/critically ill patient.

In recent years, several safety alerts have questioned or restricted the use of some pharmacological alternatives to allogeneic blood transfusion in established indications. In contrast, there seems to be a promotion of other alternatives, based on blood products and/or antifibrinolytic drugs, which lack a solid scientific basis. The Multidisciplinary Autotransfusion Study Group and the Anemia Working Group España convened a multidisciplinary panel of 23 experts belonging to different healthcare areas in a forum for debate to: 1) analyze the different safety alerts referred to certain transfusion alternatives; 2) study the background leading to such alternatives, the evidence supporting them, and their consequences for everyday clinical practice, and 3) issue a weighted statement on the safety of each questioned transfusion alternative, according to its clinical use. The members of the forum maintained telematics contact for the exchange of information and the distribution of tasks, and a joint meeting was held where the conclusions on each of the items examined were presented and discussed. A first version of the document was drafted, and subjected to 4 rounds of review and updating until consensus was reached (unanimously in most cases). We present the final version of the document, approved by all panel members, and hope it will be useful for our colleagues.

Periprosthetic infection in elderly patients treated with hemiarthroplasty of the hip following intracapsular fracture. Should we use antibiotic-loaded bone cement? / Infección periprótesica en pacientes ancianos tratados mediante hemiartroplastia de cadera tras fractura intracapsular. ¿Debemos usar cementación con antibiótico?

INTRODUCTION: Prosthetic infections are a potentially devastating complication, especially in elderly patients. Antibiotic-loaded bone cement has been used both as a treatment and prophylaxis in prosthetic infection, and its use is not well documented in the prophylaxis of infection in patients who have suffered a hip fracture. MATERIAL: A retrospective descriptive was performed. The data were obtained from all the patients who underwent hip hemiarthroplasty due to a subcapital fracture between 2011 and 2017 (N=241). An epidemiological study of the patients studied was carried out. We analysed the incidence of periprosthetic infection in the groups treated with cement without antibiotic and antibiotic-loaded bone cement, as well as the protective effect of the antibiotic-loaded bone cement. At the same time, a pilot cost analysis study was carried out. RESULTS: In the group that received antibiotic-loaded bone cement (n=94) there were 8 infections (8%), while in the group with cement without antibiotic (n=147) there were 28 infections (19%). The odds ratio (OR) was calculated, showing a 55.3% reduction in the risk of developing late infection in the group that received cement with antibiotic (95% CI: 6.2-78.7%, P=.0025). The use of antibiotic-loaded bone cement led to significant cost savings per patient. CONCLUSIONS: The use of antibiotic-loaded bone cement is a protective factor in the development of late infection after hip hemiarthroplasty surgery in elderly patients with hip fracture.

From bench to bedside: Biosensing strategies to evaluate endocrine disrupting compounds based on epigenetic events and their potential use in medicine.

The relationship between endocrine system disorders and health risks due to chemical environmental compounds has become a growing concern in recent years. Involuntary exposure to endocrine disruptors (EDCs) is associated with the worldwide increase of diseases such as cancer, obesity, diabetes, and neurocortical disorders. EDCs are compounds that target the nuclear hormonereceptors (NHR) leading to epigenetic changes. Consequently, the use of biosensing strategies based on epigenetic events have a great potential to provide outstanding information about the exposition of EDCs and their evaluation in human health. This review addresses the novel trends in biosensing EDCs evaluation based on DNA methylation assays associated with different human diseases.

In vitro chondral culture under compression and shear stimuli. From mesenchymal stem cells to hyaline cartilage. / Cultivo condral in vitro bajo estímulos de compresión y cizallamiento. De las células troncales mesenquimales al cartílago hialino.

INTRODUCTION: The in vitro creation of hyaline joint cartilage is a challenge since, to date, the ex vivo synthesis of a structured tissue with the same biomechanical and histological properties of the joint cartilage has not been achieved. To simulate the physiological conditions we have designed an in vitro culture system that reproduces joint movement. MATERIAL AND METHOD: We have developed a cell culture bioreactor that prints a mechanical stimulus on an elastin matrix, in which mesenchymal stem cells (MSC) are embedded. The first phase of study corresponds to the development of a bioreactor for hyaline cartilage culture and the verification of cell viability in the elastin matrix in the absence of stimulus. The second phase of the study includes the MSC culture under mechanical stimulus and the analysis of the resulting tissue. RESULTS: After culture under mechanical stimulation we did not obtain hyaline tissue due to lack of cellularity and matrix destructuring. CONCLUSION: The stimulus pattern used has not been effective in generating hyaline cartilage, so other combinations should be explored in future research.

[Total knee arthroplasty infection, what is the best strategy for better functional outcomes?] / Infección periprotésica de rodilla ¿influye la estrategia quirúrgica en el resultado funcional?

INTRODUCTION: Surgical strategy in dealing with periprosthetic knee infections remains controversial. The goals of treatment are to eradicate infection, improve pain and joint function. Surgical management includes implant debridement and retention, prosthetic replacement in one-time, or two-stage replacement. This latest surgical strategy is considered the «gold standard¼, reaching healing rates up to 80%-100%, although little has been published about functional results. MATERIAL AND METHODS: Retrospective study of 65 patients with periprosthetic knee infection. In 20 patients a replacement was made in a time and in 45 patients were in two stages. Pre- and post-operative evaluation with the modified HSS scale. All patients were treated with intravenous antibiotherapy, we evaluated the analytical and clinical response to confirm the eradication or not of the infection. RESULTS: The infection was resolved in 39 out of 65 patients, 12 in the replacement group in a time and 27 for the two-stages group. No significant difference between the groups in relation to healing or functional result. However, there is a statistically significant difference between those patients who received oral antibiotic treatment prior to diagnosis and those who did not. CONCLUSIONS: The healing rate is similarly treated with replacement in a time and replacement in two times. We were unable to demonstrate superiority in the functional results between the two groups.

INTRODUCCIÓN: La estrategia quirúrgica al enfrentarnos a las infecciones periprotésicas de rodilla sigue siendo controvertida. Los objetivos del tratamiento son la erradicación de la infección, la mejoría del dolor y de la función articular. El manejo quirúrgico incluye el desbridamiento y retención del implante, el recambio protésico en un tiempo o el recambio en dos tiempos. Esta última estrategia quirúrgica se considera el «gold standard¼, alcanzando unas tasas de curación hasta de 80%-100%, aunque poco se ha publicado acerca de los resultados funcionales. MATERIAL Y MÉTODOS: Estudio retrospectivo de 65 pacientes, con infección periprotésica de rodilla. En 20 pacientes se realizó un recambio en un tiempo y en 45 pacientes fueron recambios en dos tiempos. Evaluación pre- y postoperatoriamente con la escala modificada HSS. Todos los pacientes fueron tratados con antibioterapia intravenosa, evaluamos la respuesta analítica y clínica para confirmar la erradicación o no de la infección. RESULTADOS: La infección se resolvió en 39 de 65 pacientes, 12 en el grupo de recambio en un tiempo y 27 para el grupo de dos tiempos. Sin diferencia significativa entre los grupos en relación con curación ni resultado funcional. Sin embargo, hay una diferencia estadísticamente significativa entre aquellos pacientes que recibieron tratamiento antibiótico vía oral antes del diagnóstico y aquéllos que no lo recibieron. CONCLUSIÓN: La tasa de curación es similar en los tratados con recambio en un tiempo y recambio en dos tiempos. No pudimos demostrar superioridad en los resultados funcionales entre los dos grupos.

Device for characterization of thermal effusivity of liquids using photothermal beam deflection.

We propose and study a novel optoelectronic device for thermal characterization of materials. It is based on monitoring the photothermal deflection of a laser beam within a slab of a thermo-optic material in thermal contact with the sample under study. An optical angle sensor is used to measure the laser deflection providing a simple and experimental arrangement. We demonstrate its principle and a simple procedure to measure thermal effusivity of liquids. The proposed device could be implemented into a compact sensor head for remote measurements using electrical and fiber optic links.

Optical device for thermal diffusivity determination in liquids by reflection of a thermal wave.

In this work, we present a device for determination of the thermal diffusivity using the oblique reflection of a thermal wave within a solid slab that is in contact with the medium to be characterized. By using the reflection near a critical angle under the assumption that thermal waves obey Snell's law of refraction with the square root of the thermal diffusivities, the unknown thermal diffusivity is obtained by simple formulae. Experimentally, the sensor response is measured using the photothermal beam deflection technique within a slab that results in a compact device with no contact of the laser probing beam with the sample. We describe the theoretical basis and provide experimental results to validate the proposed method. We determine the thermal diffusivity of tridistilled water and glycerin solutions with an error of less than 0.5%.

Differentiation of fibrotic liver tissue using laser-induced breakdown spectroscopy.

Hepatic cirrhosis is a major cause of morbidity and mortality worldwide due to hepatitis C, alcoholism and fatty liver disease associated with obesity. Assessment of hepatic fibrosis relies in qualitative histological evaluation of biopsy samples. This method is time-consuming and depends on the histopathologists' interpretation. In the last decades, non-invasive techniques were developed to detect and monitor hepatic fibrosis. Laser-induced breakdown spectroscopy (LIBS) is a good candidate for a real-time, independent and fast technique to diagnose hepatic fibrosis. In this work LIBS was employed to characterize rat liver tissues with different stages of fibrosis. Depth profiling measurements were carried out by using a nanosecond Nd:YAG laser operated at the fundamental wavelength and an echelle spectrometer coupled with an ICCD camera. Due to the soft nature of the samples, plasma conditions largely change between consecutives shots. Thus, a theoretically supported procedure to correct the spectral line intensities was implemented. This procedure allows the reduction of the intensities' dispersion from 67% to 12%. After the correction, the LIBS signal shows an enhancement in calcium intensity by a factor of three as the fibrosis progressed. Calcium is known to increase crosslinking of extracellular matrix proteins in the fibrous septa. Therefore, our result singles it out as a key participant in the hepatic fibrosis.

[Effect of low-dose intravenous ketamine in postoperative analgesia for hysterectomy and adnexectomy]. / Efecto de dosis bajas intravenosas de ketamina en la analgesia postoperatoria de histerectomía y anexectomía.

OBJECTIVE: To evaluate the efficacy of low dose ketamine (0.15 mg/Kg i.v.) as a pre-emptive pain relief after general anesthesia. METHOD: Sixty-nine gynecological surgery patients were enrolled in this prospective, double-blind study. All received total intravenous anesthesia and were randomized to group A (n = 23) to receive preoperative ketamine, to group B (n = 23) to receive postoperative ketamine or to group C (n = 23) to receive placebo. A patient-controlled anesthesia device with morphine and ketorolac was used to provide postoperative pain relief. We evaluated the time taken to resume spontaneous breathing and to administer the first analgesic dose; the pain score on a visual analogue scale at rest at 1, 6, 24, 48 h and on the fifth day, and upon movement on the first and fifth days; and morphine consumption at 6, 24 and 48 h. RESULTS: Recovery of spontaneous breathing occurred later in group B (10 +/- 5 min) than in group A (6.68 +/- 3.64 min; p < 0.05) or in group C (8 +/- 4 min). The first analgesic dose was infused later in group B (45.24 +/- 16.16 min; p < 0.001) than in group A (26.45 +/- 11.65 min) or in group C (25.47 +/- 9.19 min). The pain scores at rest were similar. On the fifth day, pain upon movement was less intense for patients treated with ketamine (group A 12 [10-21] and group B 13.5 [2-22]) than in patients treated with placebo (group C 23 [15.5-36.75]) (p < 0.05 group C vs. group A; and p < 0.01 group C vs. group B). Morphine consumption at 6 h was less in group B than group C (p < 0.01). CONCLUSIONS: A low dose of ketamine has no preemptive analgesic effect.

[Sedation in spinal anesthesia. Comparison of remifentanil and propofol]. / Estudio comparativo entre remifentanilo y propofol para la sedación en anestesia subaracnoidea.

OBJECTIVES: To assess the efficacy and safety of remifentanil for analgesia and sedation during subarachnoidea anesthesia, and to compare remifentanil with propofol. METHOD: Ninety ASA I-III patients undergoing orthopedic or traumatologic surgery under subarachnoid anesthesia were enrolled for prospective study and randomly assigned to two treatment groups. The propofol group (n = 45) received a single dose of 0.5 mg/kg followed by infusion at 3 mg/kg/h. The remifentanil group (n = 45) received a single dose of 0.5 microgram/kg followed by infusion at 0.1 microgram/kg/min. We evaluated quality of sedation, pain intensity during nerve blockade, hemodynamic and respiratory parameters and time until recovery. RESULTS: The remifentanil group experienced less moderate-to-intense pain (13%) than did the propofol group (63%) (p < 0.01). Sedation was adequate in both groups and was easy to control by adjusting the rate of infusion. Times until recovery of consciousness and respiratory frequency after withdrawal of infusion until recovery of baseline levels were 7.87 +/- 3.54 min and 5.22 +/- 2.49 min, respectively, in the remifentanil group and 8.72 +/- 4.59 min and 5.36 +/- 2.49 min, respectively, in the propofol group, respectively. Patients in the remifentanil group experienced a significantly greater decrease in SpO2 than did those in the propofol group (20% and 4%, respectively; p < 0.05). Mean blood pressure was higher for patients treated with remifentanil. The incidence of vomiting was also higher in the remifentanil group than in the propofol group (9% vs 0%). CONCLUSION: Remifentanil is more effective in reducing pain related to nerve blockade and level of sedation is lower; however remifentanil is associated with a higher incidence of respiratory depression and vomiting.

Infección periprotésica de rodilla ¿influye la estrategia quirúrgica en el resultado funcional? / Total knee arthroplasty infection, what is the best strategy for better functional outcomes?

Resumen: Introducción: La estrategia quirúrgica al enfrentarnos a las infecciones periprotésicas de rodilla sigue siendo controvertida. Los objetivos del tratamiento son la erradicación de la infección, la mejoría del dolor y de la función articular. El manejo quirúrgico incluye el desbridamiento y retención del implante, el recambio protésico en un tiempo o el recambio en dos tiempos. Esta última estrategia quirúrgica se considera el «gold standard¼, alcanzando unas tasas de curación hasta de 80%-100%, aunque poco se ha publicado acerca de los resultados funcionales. Material y métodos: Estudio retrospectivo de 65 pacientes, con infección periprotésica de rodilla. En 20 pacientes se realizó un recambio en un tiempo y en 45 pacientes fueron recambios en dos tiempos. Evaluación pre- y postoperatoriamente con la escala modificada HSS. Todos los pacientes fueron tratados con antibioterapia intravenosa, evaluamos la respuesta analítica y clínica para confirmar la erradicación o no de la infección. Resultados: La infección se resolvió en 39 de 65 pacientes, 12 en el grupo de recambio en un tiempo y 27 para el grupo de dos tiempos. Sin diferencia significativa entre los grupos en relación con curación ni resultado funcional. Sin embargo, hay una diferencia estadísticamente significativa entre aquellos pacientes que recibieron tratamiento antibiótico vía oral antes del diagnóstico y aquéllos que no lo recibieron. Conclusión: La tasa de curación es similar en los tratados con recambio en un tiempo y recambio en dos tiempos. No pudimos demostrar superioridad en los resultados funcionales entre los dos grupos.

Abstract: Introduction: Surgical strategy in dealing with periprosthetic knee infections remains controversial. The goals of treatment are to eradicate infection, improve pain and joint function. Surgical management includes implant debridement and retention, prosthetic replacement in one-time, or two-stage replacement. This latest surgical strategy is considered the «gold standard¼, reaching healing rates up to 80%-100%, although little has been published about functional results. Material and methods: Retrospective study of 65 patients with periprosthetic knee infection. In 20 patients a replacement was made in a time and in 45 patients were in two stages. Pre- and post-operative evaluation with the modified HSS scale. All patients were treated with intravenous antibiotherapy, we evaluated the analytical and clinical response to confirm the eradication or not of the infection. Results: The infection was resolved in 39 out of 65 patients, 12 in the replacement group in a time and 27 for the two-stages group. No significant difference between the groups in relation to healing or functional result. However, there is a statistically significant difference between those patients who received oral antibiotic treatment prior to diagnosis and those who did not. Conclusions: The healing rate is similarly treated with replacement in a time and replacement in two times. We were unable to demonstrate superiority in the functional results between the two groups.

Spectroscopic refractometer for transparent and absorbing liquids by reflection of white light near the critical angle.

We propose and evaluate a spectroscopic refractometer device to measure the refractive index dispersion of transparent and absorbing solutions. The angle-dependent reflectivity of a white beam of light in an internal reflection configuration around the critical angle is spectrally analyzed. The refractive index in a wavelength range from 400 nm to 900 nm is obtained from the angle-reflectivity curve around the critical angle at each wavelength. The device does not use angle scanning mechanisms, decreasing considerably the complexity of the instrument in comparison to previous proposals. As a result, the measurements are obtained relatively fast. Nevertheless, a good experimental resolution in refractive index of about Δn ≈ 10(-4) at all the wavelengths is achieved in the case of transparent solutions. The calibration procedure of the device is discussed in detail. We also present measurements of the refractive index dispersion of rhodamine 6G-methanol solutions, which has a strong absorption band in the visible spectra.

[Juvenile glaucoma and optic disc pit with macular detachment in Klinefelter's syndrome]. / Glaucoma juvenil y foseta papilar con desprendimiento macular asociado a síndrome de Klinefelter.

CASE REPORT: A 34- year- old man affected by Klinefelter syndrome, with loss of vision in his left eye, ocular hypertension with increased cupping in both eyes, and optic disc pit with serous macular detachment in the left eye. Optical coherence tomography showed a macular detachment with a double-layer detachment, consisting of both an inner layer separation and an outer layer detachment. The outer layer detachment did not seem to communicate with the optic disc. DISCUSSION: Klinefelter syndrome has been associated with diffuse choroidal atrophy and colobomas of the iris and choroid. Our patient showed bilateral juvenile glaucoma and unilateral congenital optic disc pit. This association has not been previously reported in the bibliography.