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1.
Actas Dermosifiliogr ; 115(1): 36-47, 2024 Jan.
Article En, Es | MEDLINE | ID: mdl-37678633

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had typical scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of the cases of scabies studied, the patient had already received treatment. In those cases, we observed several remediable shortcomings that could explain why some of these treatments had failed. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.


Scabies , Humans , Female , Scabies/drug therapy , Scabies/epidemiology , Spain/epidemiology , Cross-Sectional Studies , Treatment Failure , Academies and Institutes
2.
Actas Dermosifiliogr ; 115(1): T36-T47, 2024 Jan.
Article En, Es | MEDLINE | ID: mdl-37923079

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had clinical features of classic scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of scabies cases, the patient has already received treatment. In those cases, we observe several remediable shortcomings that could explain why some of these treatments fail. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.


Scabies , Humans , Female , Scabies/diagnosis , Scabies/drug therapy , Scabies/epidemiology , Spain/epidemiology , Cross-Sectional Studies , Treatment Failure , Academies and Institutes
3.
Br J Dermatol ; 186(1): 142-152, 2022 01.
Article En | MEDLINE | ID: mdl-34254291

BACKGROUND: Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are poorly characterized. OBJECTIVE: To describe and classify cutaneous reactions after SARS-CoV-2 vaccination. METHODS: A nationwide Spanish cross-sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face-to-face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. RESULTS: From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer-BioNTech; 40·2%), mRNA-1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site ('COVID arm', 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea-like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA-1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer-BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA-1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. CONCLUSIONS: Cutaneous reactions after SARS-CoV-2 vaccination are heterogeneous. Most are mild-to-moderate and self-limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients.


COVID-19 Vaccines , COVID-19 , 2019-nCoV Vaccine mRNA-1273 , BNT162 Vaccine , ChAdOx1 nCoV-19 , Cross-Sectional Studies , Female , Humans , Middle Aged , SARS-CoV-2 , Vaccination/adverse effects
4.
Int J Mol Sci ; 22(11)2021 Jun 01.
Article En | MEDLINE | ID: mdl-34206067

Nanozymes, nanomaterials with enzyme-like activities, are becoming powerful competitors and potential substitutes for natural enzymes because of their excellent performance. Nanozymes offer better structural stability over their respective natural enzymes. In consequence, nanozymes exhibit promising applications in different fields such as the biomedical sector (in vivo diagnostics/and therapeutics) and the environmental sector (detection and remediation of inorganic and organic pollutants). Prussian blue nanoparticles and their analogues are metal-organic frameworks (MOF) composed of alternating ferric and ferrous irons coordinated with cyanides. Such nanoparticles benefit from excellent biocompatibility and biosafety. Besides other important properties, such as a highly porous structure, Prussian blue nanoparticles show catalytic activities due to the iron atom that acts as metal sites for the catalysis. The different states of oxidation are responsible for the multicatalytic activities of such nanoparticles, namely peroxidase-like, catalase-like, and superoxide dismutase-like activities. Depending on the catalytic performance, these nanoparticles can generate or scavenge reactive oxygen species (ROS).


Ferrocyanides/chemistry , Metal-Organic Frameworks/chemistry , Nanoparticles/chemistry , Nanostructures/chemistry , Catalase , Catalysis , Coordination Complexes/chemistry , Iron/chemistry , Oxidation-Reduction , Peroxidase , Reactive Oxygen Species
5.
Rev Esp Quimioter ; 34(4): 365-370, 2021 Aug.
Article Es | MEDLINE | ID: mdl-33887889

OBJECTIVE: To control the pandemic caused by SARS-CoV-2, the implementation of social and hygienic confinement measures was determined in all countries. These measures reduce the circulation of most respiratory viruses that are transmitted preferentially by air and contact. METHODS: The impact of these measures on non-Covid respiratory viruses during the period August-December 2020 and 2019 has been comparatively analyzed. To all nasopharyngeal aspirates that were negative against SARS-CoV-2 by RT-PCR and the suspicion of acute respiratory infection persisted, were subjected to a new RT-PCR that simultaneously and differentially amplifies 21 different respiratory viruses. RESULTS: In the year of the pandemic, a 36.6% decrease was detected in the number of respiratory samples studied and 66% in their positivity in relation to 2019. All viruses showed reduction percentages of between 40-100%. The only viruses that circulated during and after national lockdown were rhinovirus (74.1%), adenovirus (10.1%), and enterovirus (9.6%). CONCLUSIONS: The measures used to control the SARS-CoV-2 infection have also affected the community circulation of most respiratory viruses including influenza and respiratory syncytial virus.


COVID-19/prevention & control , Hygiene , Physical Distancing , Respiratory Tract Diseases/epidemiology , Virus Diseases/epidemiology , Communicable Disease Control , Humans , Influenza, Human/epidemiology , Nasopharynx/virology , Pandemics , Real-Time Polymerase Chain Reaction , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Tract Infections/epidemiology , Spain/epidemiology
6.
Colloids Surf B Biointerfaces ; 172: 646-654, 2018 Dec 01.
Article En | MEDLINE | ID: mdl-30243218

The very slow progress in the therapeutic efficacy of the treatment of severe diseases has suggested the use of a growing need for a multidisciplinary approach to the delivery of therapeutics to targets tissues. There has been increasing effort in the design of stimuli-responsive nanomaterials that they will be developed into effective drug delivery vehicles. Most commonly, effective drug delivery is associated with nanomaterial-facilitated accumulation and/or cellular internalization. Recent studies in our lab have demonstrated that gelatin-based NPs can be considered suitable pH responsive devices for the effective intracellular delivery of drugs. Concerning cancer treatment, ligands recognizing tumour-associated antigens expressed on the surface of the tumour cells have been employed. Some of the target structures suitable for tumour targeting belong to integrins which mediate cell adhesion to extracellular matrix and other cells. Interestingly, gelatin chains contain motifs such as RGD sequences that can be recognised by integrins. In this work the inclusion of the anticancer drug 5-fluorouracil (5-FU) on these gelatin-based NPs has been projected. These NPs may provide an opportunity to increase the therapeutic effect using a dual approach by: i) targeting the therapeutic drug to the tumour cells by the action of the naturally occurring RGD-motif on gelatin and ii) minimizing the non-productive trafficking from endosomes to lysosomes by releasing the cargo using the charge reversal approach after cellular internalization. In vitro cytotoxicity experiments of NPs on tumoral and non-tumoral cell lines have reported selectivity indexes higher than 30 demonstrating a great selectivity on the mode of action as a function of the cell line and the imposed compositions.


Fluorouracil/pharmacology , Gelatin/chemistry , Nanoparticles/chemistry , 3T3 Cells , Acids/chemistry , Animals , Cattle , Cell Death/drug effects , HeLa Cells , Humans , Hydrogen-Ion Concentration , MCF-7 Cells , Mice , Particle Size , Protamines/chemistry
7.
Clin Exp Dermatol ; 41(3): 287-9, 2016 Apr.
Article En | MEDLINE | ID: mdl-26206410

Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory disease affecting the skin folds. Multiple therapeutic options have been proposed for severe cases, but persistent responses are rarely seen. Important complications of HS are uncommon, and usually seen only in severe and unresponsive disease. Amyloid A (AA) amyloidosis is secondary to inflammatory chronic diseases, and is an uncommon complication of dermatological diseases. Only a few cases related with HS have been reported. We report the case of a 37-year-old patient who developed AA amyloidosis secondary to severe HS.


Amyloidosis/etiology , Hidradenitis Suppurativa/complications , Kidney Diseases/etiology , Adult , Chronic Disease , Female , Humans , Nephrotic Syndrome/etiology
8.
Colloids Surf B Biointerfaces ; 134: 156-68, 2015 Oct 01.
Article En | MEDLINE | ID: mdl-26188853

The rapidly rising demand for therapeutic grade DNA molecules requires associated improvements in encapsulation and delivery technologies. One of the challenges for the efficient intracellular delivery of therapeutic biomolecules after their cell internalization by endocytosis is to manipulate the non-productive trafficking from endosomes to lysosomes, where degradation may occur. The combination of the endosomal acidity with the endosomolytic capability of the nanocarrier can increase the intracellular delivery of many drugs, genes and proteins, which, therefore, might enhance their therapeutic efficacy. Among the suitable compounds, the gelification properties of gelatin as well as the strong dependence of gelatin ionization with pH makes this compound an interesting candidate to be used to the effective intracellular delivery of active biomacromolecules. In the present work, gelatin (either high or low gel strength) and protamine sulfate has been selected to form particles by interaction of oppositely charged compounds. Particles in the absence of DNA (binary system) and in the presence of DNA (ternary system) have been prepared. The physicochemical characterization (particle size, polydispersity index and degree of DNA entrapment) have been evaluated. Cytotoxicity experiments have shown that the isolated systems and the resulting gelatin-based nanoparticles are essentially non-toxic. The pH-dependent hemolysis assay and the response of the nanoparticles co-incubated in buffers at defined pHs that mimic extracellular, early endosomal and late endo-lysosomal environments demonstrated that the nanoparticles tend to destabilize and DNA can be successfully released. It was found that, in addition to the imposed compositions, the gel strength of gelatin is a controlling parameter of the final properties of these nanoparticles. The results indicate that these gelatin-based nanoparticles have excellent properties as highly potent and non-toxic intracellular delivery systems, rendering them promising DNA vehicles to be used as non-viral gene delivery systems.


Biocompatible Materials , DNA/administration & dosage , Gelatin/chemistry , Nanoparticles/chemistry , 3T3 Cells , Animals , Drug Carriers , HeLa Cells , Hemolysis , Humans , Mice , Protamines/chemistry , Rats
9.
Langmuir ; 31(37): 10161-72, 2015 Sep 22.
Article En | MEDLINE | ID: mdl-26161460

Mixed monolayers of E2(279-298), a synthetic peptide belonging to the structural protein E2 of the GB virus C (GBV-C), formerly know as hepatitis G virus (HGV), and the phospholipids dipalmitoylphosphatidyl choline (DPPC) and dimiristoylphosphatidyl choline (DMPC),which differ in acyl chains length, were obtained at the A/W interface (monolayers of extension) in order to provide new insights on E2/phospholipids interaction. Analysis of the surface pressure-area isotherms, Brewster angle microscopy images, relative thickness, and mean areas per molecule has allowed us to establish the conditions under which the mixed components of the monolayer are miscible or immiscible and know how the level of the E2/phospholipid interaction varies with the composition of the mixed films, the surface pressure, and the hydrocarbon chains length of the phospholipids. The steric hindrance caused by the penetration of the polymer strands into the more or less ordered hydrocarbon chains of the phospholipids was suggested to explain the differences in the peptide interaction with the phospholipids studied. Therefore, the novelty of results obtained with the Langmuir film balance technique, supplemented with BAM images allow us to achieve a deeper understanding of the interaction.


Choline/chemistry , Peptides/chemistry , Phospholipids/chemistry , 1,2-Dipalmitoylphosphatidylcholine/analogs & derivatives , 1,2-Dipalmitoylphosphatidylcholine/chemistry
10.
Actas dermo-sifiliogr. (Ed. impr.) ; 105(7): 699-705, sept. 2014. ilus, tab
Article Es | IBECS | ID: ibc-127771

INTRODUCCIÓN Y OBJETIVOS: El pilomatricoma es la segunda neoformación cutánea más frecuente en la infancia y la juventud, con un amplio diagnóstico diferencial. El objetivo principal del estudio fue determinar la incidencia de pilomatricomas en nuestro hospital y sus características en relación con: edad, sexo, localización, síntomas, traumatismo previo, diagnóstico clínico, enfermedades asociadas, casos múltiples, características ecográficas, tratamiento quirúrgico y técnica anestésica y complicaciones posteriores. MATERIAL Y MÉTODO: Se recogieron de forma retrospectiva los pilomatricomas extirpados quirúrgicamente en nuestro hospital de enero de 2004 a diciembre de 2012 a partir de la base de datos de anatomía patológica. RESULTADOS: Se estudiaron 261 pilomatricomas en 239 pacientes, 120 eran mujeres y 119 varones de edades comprendidas entre 1 y 83 años, con una media de 26,4 años. La forma de presentación más frecuente fue como un nódulo firme, subcutáneo, asintomático en el 82% de los casos. La localización más frecuente fue la cabeza y el cuello (49,81%). El diagnóstico clínico preoperatorio fue acertado en el 54,4%. Cincuenta y nueve pacientes tenían otras enfermedades y 7 recordaban traumatismo previo en la zona. Se registraron 17 casos múltiples, uno familiar, y 2 en pacientes con enfermedad de Steinert. En 57 lesiones se realizó ecografía de partes blandas, con imágenes compatibles con pilomatricoma en 48. Ciento ochenta y cinco pilomatricomas se extirparon con anestesia local y 76 con anestesia local y general. Como complicaciones posquirúrgicas hubo un caso de cicatriz hipertrófica y otro de dehiscencia. CONCLUSIONES: El nuestro es el estudio retrospectivo que recoge el mayor número de casos en nuestro país y uno de los que comunica mayor incidencia de casos. Además, se estudian variables no recogidas en otras series


BACKGROUND AND OBJECTIVES: Pilomatricoma is the second most common skin tumor in childhood and youth and it has a broad differential diagnosis. The main objective of the present study was to determine the incidence of pilomatricomas in our hospital and to analyze the following variables: patient age and sex, tumor site, symptoms, previous trauma, clinical diagnosis, associated diseases, number of cases of multiple tumors, ultrasound findings, anesthetic and surgical techniques, and postoperative complications. MATERIAL AND METHOD: This was a retrospective study of the pilomatricomas surgically excised between January 2004 and December 2012 and registered in the database of the pathology department of our hospital. RESULTS: We found 261 pilomatricomas in 239 patients (120 female and 119 male) between 1 and 83 years of age (mean age, 26.4 years). The most common presentation was as a firm subcutaneous nodule, which was asymptomatic in 82% of cases. Tumors most commonly affected the head and neck (49.81%). Preoperative diagnosis was correct in 54.4% of cases, concomitant diseases were present in 59 cases, and 7 patients reported a history of trauma in the area of the tumor. There were 17 cases of multiple tumors, 1 case in a patient with familial disease and 2 in patients with Steinert disease. Soft-tissue ultrasound was performed on 57 lesions; images were compatible with pilomatricoma in 48 cases. Tumor excision was performed under local anesthesia in 185 cases and under local and general anesthesia in 76. The postoperative complications were hypertrophic scarring and wound dehiscence (1 case each). CONCLUSIONS: This was a retrospective study with the largest series recorded in Spain and with one of the highest incidences. In addition, we report on variables not described in other studies


Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Diagnosis, Differential , Cicatrix, Hypertrophic/complications , Cicatrix, Hypertrophic/diagnosis , Cicatrix, Hypertrophic/surgery , Retrospective Studies , Skin Neoplasms/epidemiology , Postoperative Complications/pathology
13.
Actas Dermosifiliogr ; 105(7): 699-705, 2014 Sep.
Article En, Es | MEDLINE | ID: mdl-24838222

INTRODUCTION AND OBJECTIVES: Pilomatricoma is the second most common skin tumor in childhood and youth and it has a broad differential diagnosis. The main objective of the present study was to determine the incidence of pilomatricomas in our hospital and to analyze the following variables: patient age and sex, tumor site, symptoms, previous trauma, clinical diagnosis, associated diseases, number of cases of multiple tumors, ultrasound findings, anesthetic and surgical techniques, and postoperative complications. MATERIAL AND METHOD: This was a retrospective study of the pilomatricomas surgically excised between January 2004 and December 2012 and registered in the database of the pathology department of our hospital. RESULTS: We found 261 pilomatricomas in 239 patients (120 female and 119 male) between 1 and 83 years of age (mean age, 26.4 years). The most common presentation was as a firm subcutaneous nodule, which was asymptomatic in 82% of cases. Tumors most commonly affected the head and neck (49.81%). Preoperative diagnosis was correct in 54.4% of cases, concomitant diseases were present in 59 cases, and 7 patients reported a history of trauma in the area of the tumor. There were 17 cases of multiple tumors, 1 case in a patient with familial disease and 2 in patients with Steinert disease. Soft-tissue ultrasound was performed on 57 lesions; images were compatible with pilomatricoma in 48 cases. Tumor excision was performed under local anesthesia in 185 cases and under local and general anesthesia in 76. The postoperative complications were hypertrophic scarring and wound dehiscence (1 case each). CONCLUSIONS: This was a retrospective study with the largest series recorded in Spain and with one of the highest incidences. In addition, we report on variables not described in other studies.


Hair Diseases , Pilomatrixoma , Skin Neoplasms , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Hair Diseases/pathology , Hair Diseases/surgery , Humans , Infant , Male , Middle Aged , Pilomatrixoma/pathology , Pilomatrixoma/surgery , Retrospective Studies , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Young Adult
14.
An. pediatr. (2003, Ed. impr.) ; 80(5): 299-303, mayo 2014. tab
Article Es | IBECS | ID: ibc-122029

INTRODUCCIÓN: El citomegalovirus (CMV) es principal virus causante de infecciones congénitas y posnatales en la población pediátrica. El objetivo de este estudio es evaluar la utilidad de una PCR cuantitativa en tiempo real en el diagnóstico de estas infecciones utilizando la orina como única muestra. PACIENTES Y MÉTODOS: Se estudiaron todas aquellas muestras de orina de recién nacidos (< 7 días) con sospecha de infección congénita y las orinas de pacientes con sospecha de infección posnatal (orina al nacer negativa). Las orinas se han estudiado de forma simultánea mediante cultivo celular, PCR cualitativa (PCRc) y PCR cuantitativa en tiempo real (PCRq). RESULTADOS: Se han analizado 332 orinas (270 para descartar infección congénita y 62 infección posnatal). De las primeras 22, fueron positivas en la PCRq, 19 en la PCRc y 17 en el cultivo. Al comparar el cultivo con el resto de técnicas, la PCRq presentó una sensibilidad del 100%. Si se utiliza la PCRq como referencia, el cultivo presentó una sensibilidad del 77,2% y la PCRc del 86,3%. En los casos de infección posnatal, la PCRq detectó 16 positivas, la PCRc 12 y el cultivo celular 10 orinas como positivas. Las orinas presentaron unas cargas virales que oscilaban entre 2.178 y 116.641 copias/ml. CONCLUSIONES: La técnica de amplificación genómica PCRq en tiempo real se ha mostrado más sensible que las otras técnicas analizadas. Esta técnica debería ser considerada como de referencia (gold standard), dejando al cultivo celular como técnica secundaria. El bajo coste y la automatización de la PCRq permitirían realizar el cribado de infección por CMV a grandes poblaciones neonatales y posnatales


INTRODUCTION: Cytomegalovirus (CMV) is the main virus causing congenital and postnatal infections in the pediatric population. The aim of this study is to evaluate the usefulness of a quantitative real-time PCR in the diagnosis of these infections using urine as a single sample. PATIENTS AND METHODS: We studied all the urine samples of newborns (< 7 days) with suspected congenital infection, and urine of patients with suspected postnatal infection (urine negative at birth). Urines were simultaneously studied by cell culture, qualitative PCR (PCRc), and quantitative real-time PCR (PCRq). RESULTS: We analyzed 332 urine samples (270 to rule out congenital infection and 62 postnatal infections). Of the first, 22 were positive in the PCRq, 19 in the PCRc, and 17 in the culture. PCRq had a sensitivity of 100%, on comparing the culture with the rest of the techniques. Using the PCRq as a reference method, culture had a sensitivity of 77.2%, and PCRc 86.3%. In cases of postnatal infection, PCRq detected 16 positive urines, the PCRq 12, and the cell culture 10.The urines showed viral loads ranging from 2,178 to 116,641 copies/ml. CONCLUSIONS: The genomic amplification technique PCRq in real time was more sensitive than the other techniques evaluated. This technique should be considered as a reference (gold standard), leaving the cell culture as a second diagnostic level. The low cost and the automation of PCRq would enable the screening for CMV infection in large neonatal and postnatal populations


Humans , Male , Female , Infant, Newborn , Polymerase Chain Reaction , Cytomegalovirus Infections/congenital , Nucleic Acid Amplification Techniques , Cytomegalovirus/isolation & purification , Urinalysis/methods , Sensitivity and Specificity
15.
Acta pediatr. esp ; 72(3): e105-e110, mar. 2014. ilus
Article Es | IBECS | ID: ibc-121822

Las lesiones cutáneas por extravasación se producen por la salida o introducción directa de fármacos o líquidos al tejido celular subcutáneo en el transcurso de un tratamiento intravenoso. Los fármacos que con mayor frecuencia producen daño por extravasación son las soluciones hiperosmolares, los agentes vasopresores y los quimioterápicos. El gluconato cálcico es un ácido débil que se comporta como una solución hipertónica. Los neonatos, los ancianos y los pacientes ingresados en unidades de cuidados intensivos son la población que presenta este tipo de complicación con mayor frecuencia y gravedad, debido a su mala perfusión y delgadez de la piel y a la incapacidad para localizar el dolor. Los casos descritos en la bibliografía de necrosis cutánea por gluconato cálcico en neonatos son excepcionales. No hay una única forma de tratamiento de este tipo de patología. Se han empleado pautas conservadoras o tratamientos agresivos, con escisión amplia de los tejidos y cierre mediante injerto. Presentamos los casos de 2 recién nacidos con necrosis cutánea secundaria a la extravasación de gluconato cálcico, sin infección asociada, que evolucionaron favorablemente con tratamiento conservador, consistente en el empleo de apósitos de colágeno de origen porcino. Según nuestra experiencia, ésta podría ser una alternativa terapéutica útil en pacientes con esta infrecuente patología (AU)


Cutaneous injury due to extravasation is produced by leakage or direct introduction of drugs or fluids into the subcutaneous tissue during intravenous therapy. Hyperosmolar solutions, vasopressor agents and chemotherapy are the most frequently agents related to extravasation injury. Calcium gluconate is a weak acid that acts as a hypertonic solution. Infants, elderly patients and intensive care unit patients are prone to this type of complication and more serious effects can be observed in this population because of poor skin perfusion, thinning of cutaneous tissue and the inability to locate the pain. In the literature cases described of skin necrosis by calcium gluconate in neonates are exceptional. There is not standard treatment established for this pathology. Both conservative or aggressive management like wide excision of tissue and grafting has been used to treatment of this complication. We report two cases of neonatal skin necrosis secondary due to extravasation of calcium gluconate in which conservative treatment with dressings porcine collagen was successful. In our experience, this could be a useful therapeutic alternative in patients with this rare disease (AU)


Humans , Male , Female , Infant, Newborn , Calcium Gluconate/adverse effects , Extravasation of Diagnostic and Therapeutic Materials/complications , Necrosis/chemically induced , Bandages, Hydrocolloid , Collagen/therapeutic use , Dermatitis, Contact/diagnosis
16.
Biochim Biophys Acta ; 1838(5): 1274-80, 2014 May.
Article En | MEDLINE | ID: mdl-24530897

Three synthetic peptide sequences of 18 amino acid each, corresponding to different fragments of the E2 capsid protein of GB virus C (GBV-C): SDRDTVVELSEWGVPCAT (P45), GSVRFPFHRCGAGPKLTK (P58) and RFPFHRCGAGPKLTKDLE (P59) have been characterized in order to find a relationship between their physicochemical properties and the results obtained in cellular models. Experiments were performed in presence and absence of the HIV fusion peptide (FP-HIV) due to the evidences that GBV-C inhibits AIDS progression. P45 peptide showed lower surface activity and less extent of penetration into 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and 1,2-dimyristoyl-sn-glycero-3-phospho-L-serine (DMPS) (3:2, mol/mol) lipid monolayers than P58 and P59. However, P45 peptide presented higher capacity to inhibit FP-HIV induced cell-cell fusion than the other two sequences. These results were supported by fluorescence anisotropy measurements which indicated that P45 had a significant effect on the inhibition of FP-HIV perturbation of liposomes of the same lipid composition. Finally, atomic force microscopy (AFM) studies have evidenced the modification of the changes induced by the FP-HIV in the morphology of lipid bilayers when P45 was present in the medium.


GB virus C/chemistry , HIV Envelope Protein gp41/chemistry , HIV/chemistry , Lipid Bilayers/chemistry , Peptides/chemistry , Viral Envelope Proteins/chemistry , Amino Acid Sequence , Biophysics , GB virus C/metabolism , HIV/metabolism , HIV Envelope Protein gp41/metabolism , Lipid Bilayers/metabolism , Liposomes/chemistry , Liposomes/metabolism , Membrane Lipids/chemistry , Membrane Lipids/metabolism , Models, Molecular , Molecular Sequence Data , Peptides/metabolism , Viral Envelope Proteins/metabolism
17.
Rev. esp. pediatr. (Ed. impr.) ; 70(1): 5-7, ene.-feb. 2014.
Article Es | IBECS | ID: ibc-121765

Se ha estudiado de forma prospectiva la eficacia de una técnica de detección antigénica rápida tipo enzimoinmunoensayo (EIA) comparada con la técnica de aislamiento en cultivo celular tipo Shell-vial (Línea Hep-2), en la detección del VRS en muestras respiratorias pediátricas de 2007 a 2012. En este periodo se han estudiado 15.324 muestras, se han aislado 1.149 VRS (7,5%) y se han realizado 5,852 técnicas rápidas (38,1%). De ellas sólo 737 (12,5%) fueron positivas en la prueba de EIA. La sensibilidad de la detección antigénica frente al VRS debería restringirse a aquellos pacientes con altos índices de sospecha siguiendo las recomendaciones de las guías de consenso (AU)


We studied prospectively the efficacy of a rapid antigen detection technique type enzyme immunoassay (EIA) compared to cell culture isolation Shell-vial method (Line Hep-2), in the detection of RSV in pediatric respiratory samples from 2007-2012. During this period, 15,324 samples have been studied, 1.149 (7,5%) RSV have been isolated, and 5,852 (38,1%) rapid techniques have been maked. Of these, only 737 (12,5%) were positive in the EIA test. The overall sensitivity of the technique against RSV antigen was 64.1% (55,2%-73,1%). To increase profitability against RSV, antigen detection should be restricted to patients with high levels of suspicion as recommended by consensus guidelines (AU)


Humans , Male , Female , Infant , Respiratory Syncytial Virus, Human/isolation & purification , Respiratory Syncytial Virus Infections/diagnosis , Respiratory Tract Infections/microbiology , Reproducibility of Results , Antigens, Viral/isolation & purification , Prospective Studies
18.
An Pediatr (Barc) ; 80(5): 299-303, 2014 May.
Article Es | MEDLINE | ID: mdl-24103236

INTRODUCTION: Cytomegalovirus (CMV) is the main virus causing congenital and postnatal infections in the pediatric population. The aim of this study is to evaluate the usefulness of a quantitative real-time PCR in the diagnosis of these infections using urine as a single sample. PATIENTS AND METHODS: We studied all the urine samples of newborns (< 7 days) with suspected congenital infection, and urine of patients with suspected postnatal infection (urine negative at birth). Urines were simultaneously studied by cell culture, qualitative PCR (PCRc), and quantitative real-time PCR (PCRq). RESULTS: We analyzed 332 urine samples (270 to rule out congenital infection and 62 postnatal infections). Of the first, 22 were positive in the PCRq, 19 in the PCRc, and 17 in the culture. PCRq had a sensitivity of 100%, on comparing the culture with the rest of the techniques. Using the PCRq as a reference method, culture had a sensitivity of 77.2%, and PCRc 86.3%. In cases of postnatal infection, PCRq detected 16 positive urines, the PCRq 12, and the cell culture 10. The urines showed viral loads ranging from 2,178 to 116,641 copies/ml. CONCLUSIONS: The genomic amplification technique PCRq in real time was more sensitive than the other techniques evaluated. This technique should be considered as a reference (gold standard), leaving the cell culture as a second diagnostic level. The low cost and the automation of PCRq would enable the screening for CMV infection in large neonatal and postnatal populations.


Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/diagnosis , Real-Time Polymerase Chain Reaction , Cells, Cultured , Cytomegalovirus Infections/urine , Humans , Infant, Newborn , Prospective Studies
20.
Colloids Surf B Biointerfaces ; 105: 7-13, 2013 May 01.
Article En | MEDLINE | ID: mdl-23352943

The physical chemistry properties and interactions of E2 (125-139) and E2 (120-139) peptide sequences from GB virus C with model cell membranes were investigated by means of several biophysical techniques in order to gain better understanding of the effect of peptide length and lipid charge on membrane binding. The peptides, having one net negative charge at the pH of the assays, interacted with monolayers of all the phospholipids regardless of the charge but with more extent with the cationic DPTAP thus indicating that the interaction had both a hydrophobic and an electrostatic component as has been observed for other peptides of the same family. The peptides were able to leakage contents of liposomes and showed fluorescence energy transfer in vesicles depending on the vesicles lipid composition. On another hand, circular dichroism has shown that the peptides exist mainly as a mixture of disordered structure and ß-type conformations in aqueous solution but diminished its unstructured content, folding preferentially into α-helical conformation upon interaction with hydrophobic solvents or positively charged lipid surfaces. Altogether, results of this work indicate that the peptides interact at a surface level, penetrate into bilayers composed of fluid lipids and that conformational changes could be responsible for this effect.


Cell Membrane/metabolism , Lipid Bilayers/metabolism , Peptide Fragments/metabolism , Phospholipids/metabolism , Viral Envelope Proteins/metabolism , Circular Dichroism , Hydrophobic and Hydrophilic Interactions , Lipid Bilayers/chemistry , Peptide Fragments/chemistry , Phospholipids/chemistry , Protein Conformation , Spectrometry, Fluorescence , Viral Envelope Proteins/chemistry
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