Eccema de contacto / Contact eczema

PRESENTACION DEL CASO/ANTECEDENTES: la palabra eccema designa un tipo de reacción inflamatoria cutánea provocada por diferentes estímulos exógenos o endógenos. La fase aguda se caracteriza por la aparición de lesiones eritematosas y edematosas muy pruriginosas sobre las que paulatinamente van apareciendo vesículas que se rompen fácilmente y dejan costras. Generalmente se acompaña de intenso picor. Los eccemas irritativos de contacto son reacciones inflamatorias no alérgicas desencadenadas en la piel por la aplicación de un producto químico y que se manifiestan con una reacción eccematosa. No requiere sensibilización previa. La piel de los párpados es extremadamente fina y, al mismo tiempo, la mayoría de mujeres utilizan diferentes cosméticos específicos para esta zona.EVALUACION: mujer de 72 años de edad diagnosticada hace 6 años de glaucoma en monoterapia con latanoprost en envase unidosis una vez al día. En 2021 se modifica el tratamiento por travoprost + timolol una vez al día. Poco después consulta en la farmacia comunitaria porque comienza con escozor e inflamación de párpados en ambos ojos, que mejora al suspender el tratamiento. Sospechamos que es el timolol, contenido en las gotas oftálmicas utilizadas para controlar el glaucoma, el mecanismo responsable del cuadro clínico de la paciente.INTERVENCION: desde la farmacia comunitaria y ante la gran preocupación de la paciente no podemos otra cosa que aconsejar una serie de medidas no farmacológicas hasta que su médico especialista le atienda y cambie si así considere necesario. Le aconsejamos limpiar los ojos 1 o 2 veces al día con productos respetuosos con el pH de la piel, evitar el rascado de la zona y utilizar hidratantes calmantes específicamente diseñados para esa zona, no sin antes lavarse las manos. (AU)

Artrosis y farmacia / Arthrosis and pharmacy

PRESENTACIÓN DEL CASO/ANTECEDENTES: la artrosis es un síndrome de dolor articular acompañado de diversos grados de limitación funcional y reducción de la calidad de vida. Es la causa más frecuente de dolor articular. Se caracteriza por una pérdida de cartílago articular. Además de la educación al paciente para un mejor conocimiento de su enfermedad, los objetivos del tratamiento deben ser: aliviar el dolor, reducir la inflamación, mejorar la función articular y retrasar la progresión de la artrosis.EVALUACIÓN: mujer de 72 años con IMC 39. Diagnosticada de diabetes mellitus tipo II, hipercolesterolemia, lumbalgia, ansiedad, dispepsia. Tratamiento actual de Jentadueto 1/0/1, Seguril 1/0/0, Simvastatina 0/0/1, Condrosan 0/2/0, Fosavance 1/0/0 una vez por semana, Espidifen 1/0/1, Lormetazepan 0/0/1, Omeprazol 1/0/0, Adiro 0/1/0.Se realiza un seguimiento farmacoterapéutico durante tres meses, además hacemos especial hincapié en las medidas no farmacológicas, como bajar de peso y realizar ejercicio.INTERVENCION: en una de las visitas nos solicita Espidifen 600 sin receta médica, nos comenta que está tomando tres sobres al día de forma continuada. Es un RNM de inseguridad. Le informamos del riesgo de hemorragia digestiva y riesgo cardiovascular con la toma de más de 1200 mg de ibuprofeno al día y que la toma de Adiro y Espidifen, ambos AINES, incrementan la toxicidad y no la eficacia. Derivamos al médico y le prescribe Palexia Retard de 25 mg 0/1/0 y Lyrica 75 mg 1/0/0. Finalmente tras un mes de evolución, su mejoría es notable, camina y hace vida normal.RESULTADO: podemos observar como desde la farmacia comunitaria podemos atender y evitar problemas asociados a la medicación, mejorando su salud y su calidad de vida. A los pacientes con sobrepeso u obesidad se les debe animar a perder peso con una meta explícita y a mantener esa pérdida, ya que se consigue alivio del dolor, de la rigidez articular y mejoría funcional. (AU)

¿Qué podemos hacer con el Helicobacter desde la farmacia? / What can we do about Helicobacter from the pharmacy?

PRESENTACION DEL CASO/ANTECEDENTES: la infección por Helicobacter Pylori afecta a gran parte de la población, y junto con el consumo de AINE, uno de los principales factores de riesgo para el desarrollo de complicaciones de la úlcera péptica y su erradicación mejora las tasas de curación y disminuye las complicaciones, incluyendo el sangrado y la recurrencia. No existe un tratamiento erradicador ideal.EVALUACION: los trastornos digestivos generan muchas consultas, tanto en el mostrador de la farmacia comunitaria como en la consulta del médico de atención primaria. Son problemas de salud de alta prevalencia y una correcta atención farmacéutica en este ámbito puede mejorar los resultados de los tratamientos.INTERVENCION: mujer de 52 años acude a la farmacia con unas prescripciones para erradicar el Helicobacter Pylori. Refiere muchas molestias desde hace tiempo. Diagnosticada como hipertensa y sin patologías mayores, solo toma Enalapril 1/0/0. En su primer intento abandonó el tratamiento debido al gran número de pastillas y los efectos adversos asociados. Sabemos que la adherencia al tratamiento juega un papel fundamental en la erradicación del H.pylori, aunque no ha sido cuantificada. La tasa de abandonos está relacionada con el número de dosis de medicamentos que toman los pacientes. La frecuencia y gravedad de los efectos adversos también influyen sobre la adherencia, si bien los pacientes tienen un mejor cumplimiento cuando conocen los efectos adversos potenciales y entienden en qué casos estaría justificado abandonar el tratamiento, por lo que es importante discutir con ellos los beneficios y riesgos del tratamiento. (AU)

Vitamina D, ¿saben los pacientes como tomarla? / Vitamin D, do patients know how to take it?

PRESENTACION DEL CASO/ANTECEDENTES: varón de 46 años que acude a la farmacia comunitaria con mareos de una semana de evolución. En los últimos días los síntomas han aumentado, incluso con náuseas y vómitos, ligero estreñimiento y refiere una gran cantidad de orina en cada micción.EVALUACIÓN: la dispensación de vitamina D en el mostrador de la farmacia comunitaria es cada vez más frecuente, por tanto, debemos disponer de una pauta rigurosa en la dispensación de las vitaminas liposolubles. Las vitaminas son sustancias esenciales en la dieta, son biológicamente muy activas y necesarias para el mantenimiento de las funciones metabólicas y del crecimiento. Como consecuencia su aporte exógeno es fundamental mediante una dieta variada y equilibrada, o en determinados casos carenciales, mediante suplementos.INTERVENCIÓN: desde la farmacia comunitaria, revisamos su medicación y nos damos cuenta que tiene pautado calciferol 0.226 mg/mes. Hacemos una anamnesis más exhaustiva y por error el paciente ha estado tomando una dosis diaria en lugar de una mensual. Nos ponemos en contacto con el médico, que tras una analítica se confirman unos valores de vitamina D muy superiores a los de referencia, quedando confirmado una intoxicación por vitamina D.La hipercalcemia es un problema de salud relativamente común y cada vez vemos en las farmacias que se producen mas intoxicaciones de vitamina D. La hipercalcemia de produce como consecuencia de un exceso de resorción ósea, una absorción intestinal aumentada o una disminución en la excreción renal del calcio. (AU)

Development of Bioglass/PEEK Composite Coating by Cold Gas Spray for Orthopedic Implants.

Cold gas spray (CGS) technology has allowed the development of biofunctional coatings composed of 45S5 and polyetheretherketone (PEEK). The combination of a bioactive glass material embedded in a polymeric matrix makes this composite an interesting material for orthopedic applications since this composite meets the biomechanical and biological requirements of an implant. In the present study, blends of bioactive glass 45S5 and PEEK powder with different granulometry and 45S5/PEEK ratio have been prepared. These mixtures of powders have been deposited onto PEEK substrates by CGS with the goal of incorporating a bioactive additive to the biocompatible polymer, which can improve the bone-implant interaction of PEEK. The deposition efficiency (DE) of the coatings has been evaluated, and from the results obtained, it was possible to conclude that DE is significantly affected by the granulometry and by the 45S5/PEEK ratio of the blends. By scanning electron microscopy (SEM) inspection, it was observed that the use of blends with high 45S5/PEEK ratio lead to the deposition of coatings with high content of 45S5. Finally, the friction behavior of the coatings was analyzed performing ball-on-disk tests and these experiments showed that the presence of glass particles has a beneficial role in the wear resistance.

Prognostic value of myocardial perfusion scintigraphy in diabetic patients and without coronary lesion. / Valor pronóstico de la gammagrafía de perfusión miocárdica en pacientes diabéticos sin lesiones coronarias.

OBJECTIVE: To determine the prognostic value of myocardial perfusion scintigraphy-gated SPECT in patients with diabetes mellitus and without obstructive coronary artery disease. MATERIALS AND METHODS: This retrospective study included consecutive patients undergoing adenosine stress-rest myocardial perfusion imaging (MPI) by 99mTc-tetrofosmin between 2009 and 2011. The patients had diabetes mellitus and coronary angiography without significant coronary lesions. In total, 37 diabetic patients (female/male: 20/17; mean age: 65.2 (range: 40-78). 29 non-diabetic patients were included wich are matched with the group of diabetic patients with positive MPI. The group of non-diabetic patients had scintigraphy with myocardial ischemia and without angiographic lesions. A 36-month clinical follow-up was performed, and major cardiac events were recorded. RESULTS: In 78.3% (29/37) of diabetic patients the scintigraphic study showed myocardial ischemia, while it was negative in the 21.7%. The cardiac event rate in both groups was 6%. In diabetics with a myocardial perfusion study with myocardial ischemia, there were 3 major cardiac events. In diabetic patients with negative study had no cardiac event. In the non-diabetic control group the cardiac events rate was 3.4% (1/29). CONCLUSION: In diabetic patients without obstructive coronary disease, myocardial perfusion study can be predictor of cardiac events. A negative study can be an indicator of a better cardiovascular prognosis.

Toward RGB LEDs based on rare earth-doped ZnO.

By using ZnO thin films doped with Ce, Tb or Eu, deposited via radiofrequency magnetron sputtering, we have developed monochromatic (blue, green and red, respectively) light emitting devices (LEDs). The rare earth ions introduced with doping rates lower than 2% exhibit narrow and intense emission peaks due to electronic transitions in relaxation processes induced after electrical excitation. This study proves zinc oxide to be a good host for these elements, its high conductivity and optical transparency in the visible range being as well exploited as top transparent electrode. After structural characterization of the different doped layers, a device structure with intense electroluminescence is presented, modeled, and electrically and optically characterized. The different emission spectra obtained are compared in a chromatic diagram, providing a reference for future works with similar devices. The results hereby presented demonstrate three operating monochromatic LEDs, as well as a combination of the three species into another one, with a simply-designed structure compatible with current Si technology and demonstrating an integrated red-green-blue emission.

Synchronization of Optomechanical Nanobeams by Mechanical Interaction.

The synchronization of coupled oscillators is a phenomenon found throughout nature. Mechanical oscillators are paradigmatic examples, but synchronizing their nanoscaled versions is challenging. We report synchronization of the mechanical dynamics of a pair of optomechanical crystal cavities that, in contrast to previous works performed in similar objects, are intercoupled with a mechanical link and support independent optical modes. In this regime they oscillate in antiphase, which is in agreement with the predictions of our numerical model that considers reactive coupling. We also show how to temporarily disable synchronization of the coupled system by actuating one of the cavities with a heating laser, so that both cavities oscillate independently. Our results can be upscaled to more than two cavities and pave the way towards realizing integrated networks of synchronized mechanical oscillators.

Memristive behaviour of Si-Al oxynitride thin films: the role of oxygen and nitrogen vacancies in the electroforming process.

The resistive switching properties of silicon-aluminium oxynitride (SiAlON) based devices have been studied. Electrical transport mechanisms in both resistance states were determined, exhibiting an ohmic behaviour at low resistance and a defect-related Poole-Frenkel mechanism at high resistance. Nevertheless, some features of the Al top-electrode are generated during the initial electroforming, suggesting some material modifications. An in-depth microscopic study at the nanoscale has been performed after the electroforming process, by acquiring scanning electron microscopy and transmission electron microscopy images. The direct observation of the devices confirmed features on the top electrode with bubble-like appearance, as well as some precipitates within the SiAlON. Chemical analysis by electron energy loss spectroscopy has demonstrated that there is an out-diffusion of oxygen and nitrogen ions from the SiAlON layer towards the electrode, thus forming silicon-rich paths within the dielectric layer and indicating vacancy change to be the main mechanism in the resistive switching.

Moderate asymptomatic subacute eosinophilia secondary to Simvastatin Therapy

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Compact focusing grating couplers for silicon horizontal slot waveguides.

In this Letter, we present the design, simulation (2D and 3D), fabrication, and experimental characterization of compact and fully etched focusing gratings for a horizontal slot waveguide based on a silicon nitride layer sandwiched between amorphous silicon and a silicon-on-insulator. The measured coupling losses are about 4 dB with a 3 dB bandwidth of 38 nm. The fully etched configuration allows the fabrication in a single lithography step.

Aided phytostabilisation reduces metal toxicity, improves soil fertility and enhances microbial activity in Cu-rich mine tailings.

(Aided) phytostabilisation has been proposed as a suitable technique to decrease the environmental risks associated with metal(loid)-enriched mine tailings. Field scale evaluations are needed for demonstrating their effectiveness in the medium- to long-term. A field trial was implemented in spring 2011 in Cu-rich mine tailings in the NW of Spain. The tailings were amended with composted municipal solid wastes and planted with Salix spp., Populus nigra L. or Agrostis capillaris L. cv. Highland. Plant growth, nutritive status and metal accumulation, and soil physico- and bio-chemical properties, were monitored over three years (four years for plant growth). The total bacterial community, α- and ß-Proteobacteria, Actinobacteria and Streptomycetaceae were studied by DGGE of 16s rDNA fragments. Compost amendment improved soil properties such as pH, CEC and fertility, and decreased soil Cu availability, leading to the establishment of a healthy vegetation cover. Both compost-amendment and plant root activity stimulated soil enzyme activities and induced important shifts in the bacterial community structure over time. The woody plant, S. viminalis, and the grassy species, A. capillaris, showed the best results in terms of plant growth and biomass production. The beneficial effects of the phytostabilisation process were maintained at least three years after treatment.

Organosilane-functionalization of nanostructured indium tin oxide films.

Fabrication and organosilane-functionalization and characterization of nanostructured ITO electrodes are reported. Nanostructured ITO electrodes were obtained by electron beam evaporation, and a subsequent annealing treatment was selectively performed to modify their crystalline state. An increase in geometrical surface area in comparison with thin-film electrodes area was observed by atomic force microscopy, implying higher electroactive surface area for nanostructured ITO electrodes and thus higher detection levels. To investigate the increase in detectability, chemical organosilane-functionalization of nanostructured ITO electrodes was performed. The formation of 3-glycidoxypropyltrimethoxysilane (GOPTS) layers was detected by X-ray photoelectron spectroscopy. As an indirect method to confirm the presence of organosilane molecules on the ITO substrates, cyclic voltammetry and electrochemical impedance spectroscopy (EIS) were also carried out. Cyclic voltammograms of functionalized ITO electrodes presented lower reduction-oxidation peak currents compared with non-functionalized ITO electrodes. These results demonstrate the presence of the epoxysilane coating on the ITO surface. EIS showed that organosilane-functionalized electrodes present higher polarization resistance, acting as an electronic barrier for the electron transfer between the conductive solution and the ITO electrode. The results of these electrochemical measurements, together with the significant difference in the X-ray spectra between bare ITO and organosilane-functionalized ITO substrates, may point to a new exploitable oxide-based nanostructured material for biosensing applications. As a first step towards sensing, rapid functionalization of such substrates and their application to electrochemical analysis is tested in this work. Interestingly, oxide-based materials are highly integrable with the silicon chip technology, which would permit the easy adaptation of such sensors into lab-on-a-chip configurations, providing benefits such as reduced size and weight to facilitate on-chip integration, and leading to low-cost mass production of microanalysis systems.

Far-field characterization of the thermal dynamics in lasing microspheres.

This work reports the dynamical thermal behavior of lasing microspheres placed on a dielectric substrate while they are homogeneously heated-up by the top-pump laser used to excite the active medium. The lasing modes are collected in the far-field and their temporal spectral traces show characteristic lifetimes of about 2 ms. The latter values scale with the microsphere radius and are independent of the pump power in the studied range. Finite-Element Method simulations reproduce the experimental results, revealing that thermal dynamics is dominated by heat dissipated towards the substrate through the medium surrounding the contact point. The characteristic system scale regarding thermal transport is of few hundreds of nanometers, thus enabling an effective toy model for investigating heat conduction in non-continuum gaseous media and near-field radiative energy transfer.

Structural parameters effect on the electrical and electroluminescence properties of silicon nanocrystals/SiO2 superlattices.

The effect of the oxide barrier thickness (tSiO2) reduction and the Si excess ([Si]exc) increase on the electrical and electroluminescence (EL) properties of Si-rich oxynitride (SRON)/SiO2 superlattices (SLs) is investigated. The active layers of the metal-oxide-semiconductor devices were fabricated by alternated deposition of SRON and SiO2 layers on top of a Si substrate. The precipitation of the Si excess and thus formation of Si nanocrystals (NCs) within the SRON layers was achieved after an annealing treatment at 1150 °C. A structural characterization revealed a high crystalline quality of the SLs for all devices, and the evaluated NC crystalline size is in agreement with a good deposition and annealing control. We found a dramatic conductivity enhancement when the Si content is increased or the SiO2 barrier thickness is decreased, due to a larger interaction of the carrier wavefunctions from adjacent layers. EL recombination dynamics were studied, revealing radiative recombination decay times of the order of tens of microseconds. Lower lifetimes were found at higher [Si]exc, attributed to exciton confinement delocalization, whereas intermediate barrier thicknesses present the slowest decay. The electrical-to-light conversion efficiency increases monotonously at thicker barriers and smaller Si contents. We ascribe these effects mainly to free carriers, which enhance carrier transport through the SLs while strongly quenching light emission. Finally, the combination of the different results led us to conclude that tSiO2 âˆ¼ 2 nm and [Si]exc from 12 to 15 at% are the ideal structure parameters for a balanced electro-optical response of Si NC-based SLs.

Use of DMPC and DSPC lipids for verapamil and naproxen permeability studies by PAMPA.

Verapamil and naproxen Parallel Artificial Membrane Permeability Assay (PAMPA) permeability was studied using lipids not yet reported for this model in order to facilitate the quantification of drug permeability. These lipids are 1,2-distearoyl-sn-glycero-3-phosphatidylcholine (DSPC), 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and an equimolar mixture of DMPC/DSPC, both in the absence and in the presence of 33.3 mol% of cholesterol. PAMPA drug permeability using the lipids mentioned above was compared with lecithin-PC. The results show that verapamil permeability depends on the kind of lipid used, in the order DMPC > DMPC/DSPC > DSPC. The permeability of the drugs was between 1.3 and 3.5-times larger than those obtained in lecithin-PC for all the concentrations of the drug used. Naproxen shows similar permeability than verapamil; however, the permeability increased with respect to lecithin-PC only when DMPC and DMPC/DSPC were used. This behavior could be explained by a difference between the drug net charge at pH 7.4. On the other hand, in the presence of cholesterol, verapamil permeability increases in all lipid systems; however, the relative verapamil permeability respect to lecithin-PC did not show any significant increase. This result is likely due to the promoting effect of cholesterol, which is not able to compensate for the large increase in verapamil permeability observed in lecithin-PC. With respect to naproxen, its permeability value and relative permeability respect lecithin-PC not always increased in the presence of cholesterol. This result is probably attributed to the negative charge of naproxen rather than its molecular weight. The lipid systems studied have an advantage in drug permeability quantification, which is mainly related to the charge of the molecule and not to its molecular weight or to cholesterol used as an absorption promoter.

Papel de la inflamación renal en la fisiopatología de la hipertensión sensible a sal / Role of renal inflammation in the physiopathology of salt-sensitive hypertension

La hipertensión sensible a sal es el aumento de la presión arterial luego de una sobrecarga salina, como consecuencia esencialmente de una disminución en la excreción renal de sodio. En los últimos años, ha sido desarrollada una teoría para explicar su origen que tiene como base la inflamación del tejido renal. El proceso inicia con la producción en los riñones de radicales libres derivados del metabolismo oxidativo. Luego se desarrolla un mecanismo de inflamación del intersticio renal por infiltración de linfocitos T, y otras células inmunológicas. Fundamentalmente los linfocitos T incrementan la producción de angiotensina II que estimula la retención de sodio y agua a este nivel, favoreciendo el desarrollo de hipertensión sensible a sal. La relación entre infiltración renal por células del sistema inmune e hipertensión sensible a sal permite, en parte, explicar la asociación entre enfermedades autoinmunes y la hipertensión arterial. El uso de antioxidantes y el diseño de nuevos fármacos pueden ser una alternativa adicional al tratamiento de los pacientes afectados.

Salt-sensitive hypertension is produced by a decrease in salt renal excretion after a salt overload. Over the last few years, a new theory has been developed to explain this condition based on renal tissue inflammation. This process begins with free radicals production in renal tissue due to oxidative metabolism. Then they favor a renal inflammation mechanism with T-lymphocytes infiltration and other immune cells. Essentially, T-lymphocytes determine an increase in angiotensin II production which raises sodium and water retention. Association among autoimmune diseases and hypertension may be explained, in part, by the relationship between salt-sensitive hypertension and renal inflammation. The use of antioxidant drugs and the development of new medicaments may be a choice for treating patients affected with this condition.

Papel de la inflamación renal en la fisiopatología de la hipertensión sensible a sal / Role of renal inflammation in the physiopathology of salt-sensitive hypertension

La hipertensión sensible a sal es el aumento de la presión arterial luego de una sobrecarga salina, como consecuencia esencialmente de una disminución en la excreción renal de sodio. En los últimos años, ha sido desarrollada una teoría para explicar su origen que tiene como base la inflamación del tejido renal. El proceso inicia con la producción en los riñones de radicales libres derivados del metabolismo oxidativo. Luego se desarrolla un mecanismo de inflamación del intersticio renal por infiltración de linfocitos T, y otras células inmunológicas. Fundamentalmente los linfocitos T incrementan la producción de angiotensina II que estimula la retención de sodio y agua a este nivel, favoreciendo el desarrollo de hipertensión sensible a sal. La relación entre infiltración renal por células del sistema inmune e hipertensión sensible a sal permite, en parte, explicar la asociación entre enfermedades autoinmunes y la hipertensión arterial. El uso de antioxidantes y el diseño de nuevos fármacos pueden ser una alternativa adicional al tratamiento de los pacientes afectados(AU)

Er-doped light emitting slot waveguides monolithically integrated in a silicon photonic chip.

An integrated erbium-based light emitting diode has been realized in a waveguide configuration allowing 1.54 µm light signal routing in silicon photonic circuits. This injection device is based on an asymmetric horizontal slot waveguide where the active slot material is Er(3+) in SiO2 or Er(3+) in Si-rich oxide. The active horizontal slot waveguide allows optical confinement, guiding and lateral extraction of the light for on-chip distribution. Light is then coupled through a taper section to a passive Si waveguide terminated by a grating which extracts (or inserts) the light signal for measuring purposes. We measured an optical power density in the range of tens of µW/cm(2) which follows a super-linear dependence on injected current density. When the device is biased at high current density, upon a voltage pulse (pump signal), free-carrier and space charge absorption losses become large, attenuating a probe signal by more than 60 dB/cm and thus behaving conceptually as an electro-optical modulator. The integrated device reported here is the first example, still to be optimized, of a fundamental block to realize an integrated silicon photonic circuit with monolithic integration of the light emitter.