Síndrome cardiorrenal tipo 4 en paciente revascularizado percutáneamente

Introducción: el síndrome cardiorrenal es una patología dada por la disfunción en la interdependencia de estos órganos por interacciones bidireccionales (agudas o crónicas), los cuales pueden afectar indistintamente la función renal o ventricular. Objetivo: presentar y justificar la enfermedad renal crónica como desencadenante de cuadros congestivos por falla cardiaca de novo. Presentación del caso: se reporta el caso de un paciente masculino de 69 años revascularizado percutáneamente hace tres años con múltiples comorbilidades que ingresa en el contexto de una falla cardiaca de novo, secundaria a su enfermedad renal crónica estadio V de base, en manejo con hemodiálisis y en quien se descartó enfermedad coronaria aguda y miocardiopatía infiltrativa. Se logró estabilizar la injuria renal y cardiaca dando egreso y continuando manejo ambulatorio de sus patologías, al llevar un control adecuado de las mismas con Nefrología y Cardiología. Discusión y conclusión: la enfermedad cardiovascular generada por antecedentes renales tiene una gran repercusión en la función ventricular izquierda, causando hipertrofia, lo que lleva a una congestión con posterior sobrecarga debido a la caída del filtrado glomerular y que resulta en la disminución de la fracción de eyección. La enfermedad renal crónica predispone a alteraciones en la función cardiaca, lo que aumenta el riesgo cardiovascular.

Background: Cardiorenal syndrome is a pathology caused by dysfunction in the interdependence of these organs due to bidirectional interactions (acute or chronic), which can affect either renal or ventricular function. Purpose: To present and justify chronic kidney disease as a trigger of congestive conditions due to de novo heart failure. Case presentation: We report the case of a 69-year-old male patient percutaneously revascularized 3 years ago with multiple comorbidities who was admitted in the context of de novo heart failure secondary to his stage V chronic kidney disease on hemodialysis, in whom acute coronary artery disease and infiltrative cardiomyopathy were ruled out. The renal and cardiac injury was stabilized and the patient was discharged and continued outpatient management of his pathologies with adequate control of the same with nephrology and cardiology. Discussion and conclusion: Cardiovascular disease generated by renal history has great repercussion in left ventricular function causing hypertrophy that leads to congestion with subsequent overload due to the fall of glomerular filtration resulting in a decrease of the ejection fraction. Chronic kidney disease predisposes to alterations in cardiac function increasing cardiovascular risk.

Significantly enhancement of sunlight photocatalytic performance of ZnO by doping with transition metal oxides.

In this study we report, the synthesis of ZnO and its doping with Transition Metal Oxides -TMO-, such as Cr2O3, MnO2, FeO, CoO, NiO, Cu2O and CuO. Various characterization techniques were employed to investigate the structural properties. The X-ray diffraction (XRD) data and Rietveld refinement confirmed the presence of TMO phases and that the ZnO structure was not affected by the doping with TMO which was corroborated using transmission Electron microscopy (TEM). Surface areas were low due to blockage of adsorption sites by particle aggregation. TMO doping concentration in the range of 3.7-5.1% was important to calculate the catalytic activity. The UV-Visible spectra showed the variation in the band gap of TMO/ZnO ranging from 3.45 to 2.46 eV. The surface catalyzed decomposition of H2O2 was used as the model reaction to examine the photocatalytic activity following the oxygen production and the systems were compared to bulk ZnO and commercial TiO2-degussa (Aeroxyde-P25). The results indicate that the introduction of TMO species increase significantly the photocatalytic activity. The sunlight photocatalytic performance in ZnO-doped was greater than bulk-ZnO and in the case of MnO2, CoO, Cu2O and CuO surpasses TiO2 (P25-Degussa). This report opens up a new pathway to the design of high-performance materials used in photocatalytic degradation under visible light irradiation.

Heterogeneous singlet oxygen generation: in-operando visible light EPR spectroscopy.

The use of photosensitizers immobilized on mesoporous materials to produce singlet oxygen (1O2) has opened a new way to synthetic and environmental applications due to the fast development of flow photochemistry and continuous-flow microreactors. 1O2-based photosensitized processes can be employed for the degradation of organic pollutants in an aqueous medium and the photosensitizer can be covalently attached to the support and separated from the effluent reducing the environmental impact. The aim of the present paper is to evaluate the 1O2 generation of Rose Bengal (RB) in homogeneous and heterogeneous systems using in-operando evaluation. Mesoporous SiO2 nanoparticles (MSNs) were successfully conjugated with RB (MSN-RB) and electron paramagnetic resonance (EPR) spectroscopy in combination with the spin trap TEMP was employed to obtain paramagnetic TEMPO via generated 1O2 when RB or MSN-RB are exposed to visible light. Additionally, EPR/DMPO was used to exclude the possible generation of other reactive oxygen species (ROS) by the functionalized nanoparticles. We found that in situ 1O2 generation was enhanced when the same amount of RB is immobilized inside of mesoporous SiO2.

Protoporphyrin IX-Functionalized AgSiO2 Core-Shell Nanoparticles: Plasmonic Enhancement of Fluorescence and Singlet Oxygen Production.

Metal-enhanced processes arising from the coupling of a dye with metallic nanoparticles (NPs) have been widely reported. However, few studies have simultaneously investigated these mechanisms from the viewpoint of dye fluorescence and photoactivity. Herein, protoporphyrin IX (PpIX) is grafted onto the surface of silver core silica shell NPs in order to investigate the effect of silver (Ag) localized surface plasmon resonance (LSPR) on PpIX fluorescence and PpIX singlet oxygen (1 O2 ) production. Using two Ag core sizes, we report a systematic study of these photophysical processes as a function of silica (SiO2 ) spacer thickness, LSPR band position and excitation wavelength. The excitation of Ag NP LSPR, which overlaps the PpIX absorption band, leads to the concomitant enhancement of PpIX fluorescence and 1 O2 production independently of the Ag core size, but in a more pronounced way for larger Ag cores. These enhancements result from the increase in the PpIX excitation rate through the LSPR excitation and decrease when the distance between PpIX and Ag NPs increases. A maximum fluorescence enhancement of up to 14-fold, together with an increase in photogenerated 1 O2 production of up to five times are obtained using 100 nm Ag cores coated with a 5 nm thick silica coating.

Zigzag phosphorene nanoribbons: one-dimensional resonant channels in two-dimensional atomic crystals.

We theoretically investigate phosphorene zigzag nanoribbons as a platform for constriction engineering. In the presence of a constriction at one of the edges, quantum confinement of edge-protected states reveals conductance peaks, if the edge is uncoupled from the other edge. If the constriction is narrow enough to promote coupling between edges, it gives rise to Fano-like resonances as well as antiresonances in the transmission spectrum. These effects are shown to mimic an atomic chain like behavior in a two dimensional atomic crystal.

The range of validity of sorption kinetic models.

Several hundred papers are published yearly reporting liquid-phase adsorption kinetics data. In general the data is analyzed using a variety of standard models such as the pseudo first- and second-order models and the Intraparticle-Diffusion model. The validity of these models is often assessed empirically via their ability to fit the data, independently of their physicochemical soundness. The aim of the present paper is to rationalize the analysis of liquid-phase adsorption kinetics data, and to investigate experimental factors that influence the adsorption kinetics, in addition to the characteristics of the adsorbent material itself. For that purpose we use a simple Langmuir adsorption-diffusion model, which enables us to identify three dimensionless numbers that characterize the working regime of any batch adsorption experiment: an adsorption Thiele modulus, a saturation modulus, and a loading modulus. The standard models are found to be particular cases of the general adsorption-diffusion model for specific values of the dimensionless numbers. This provides sound physicochemical criteria for the validity of the models. Based on our modeling, we also propose a general yet simple data analysis procedure to practically estimate the diffusion coefficient in adsorbent pellets starting from adsorption half-times.

A one-step short-time synthesis of Ag@SiO2 core-shell nanoparticles.

A performance of shell-thickness precise control in silver-silica coating core-shell nanoparticles is presented. 60nm sized citrate-stabilized silver nanoparticles are directly silica coated using a modified Stöber process. Tetraethyl orthosilicate is used as a silica precursor and ammonium hydroxide as catalyst in an alcoholic solvent to promote the seeded silica growth. By simply varying the synthesis reaction time from 4 to 60min, the silica shell thickness is increased from 5.1nm to 76.4nm. This well-controlled synthesis is then transposed to 40, 80 and 100nm sized silver cores in order to show the independence of the silica shell growth on the nanoparticle core size. Optical properties, i.e. localized surface plasmon resonance, of the produced silver-silica core-shell are also investigated.

Gingival melanoacanthoma: case report and discussion of its clinical relevance.

Oral melanoacanthoma is an uncommon reactive condition that appears as a solitary pigmented lesion and is most often found on the buccal mucosa. For it to appear in the gingiva is extremely rare--only 11 cases are reported in the literature. This article presents a case of gingival melanoacanthoma and reviews the previously published cases. Because gingival melanoacanthoma shares clinical features with other pigmented lesions with diverse genesis, the differential diagnosis of a solitary pigmented lesion on the gingiva is also discussed.

Factores predictores de falla orgánica múltiple en pacientes traumatizados de la unidad de cuidados intensivos posquirúrgicos / Predictive factors of multiple organ failure in politraumatized patients in the post-surgical intensive care unit

El hospital militar es el centro de referencia nacional del trauma de guerra. Se buscó identificar si los predictores de falla orgánica multiple descritos se aplicaban a nuestra población: jóvenes con lesiones traumáticas severas. Se realizó un estudio observacional analítico de casos y controles anidado en una cohorte histórica, para lo cual se analizaron las historias clínicas de los pacientes con trauma entre enero de 1995 y diciembre de 1999. Se dividieron tres grupos: aquellos que desarrollaron falla orgánica múltiple, los que presentaron falla de órgano y los que no la presentaron. Se aplicaron escalas de severidad como Apache II, Injury Severity Score, Revised Trauma Score; tiempos de atención, duración de procedimientos y base exceso, todos predictores de falla orgánica múltiple. Mediante un análisis de varianza se evaluaron los resultados así: recolección de datos completos en 124 pacientes. Edad promedio 27 años, discriminados así: 50 falla orgánica múltiple, 55 sin falla orgánica múltiple y 19 en falla de órgano. Mecanismos de trauma: proyectil de alta velocidad 47 pacientes (37.9/100), accidente automovilístico 39 (31.4/100), proyectil de baja velocidad 14 (11.2/100), arma de fragmentación 13 (10.4/100), caidas 8 (6.4/100), arma cortopunzante 3 (2.4/100). Valores de Apache II: falla orgánica múltiple 15.4, fallo de órgano 10.3, sin falla orgánica múltiple 8.8. Valor de Injury Severity Score: falla organica múltiple 32.6, órgano 18.5, sin falla orgánica múltiple 15.6. Valor de Revised Trauma Score: falla orgánica múltiple 5.37, órgano 6.6, sin falla orgánica múltiple 6.4. Duración de la primera cirugía: falla orgánica múltiple 2.7 horas, órgano 2.2 horas, sin falla orgánica múltiple 2.2 horas. El desarrollo de falla orgánica múltiple se asoció a: Apache mayor de 15, base exceso menor de -11, Injury Severity Score mayor de 32, proyectiles de alta velocidad, Revised Trauma Score menor de 5.37 y tiempos de atención prolongados.

Uso del halo cefálico preoperatorio en las deformidades estructuradas de la columna vertebral / Pre-operative halo-traction in treatment of structural spinal deformities. Report of 32 cases

En el departamento de ortopedia del Hospital Universitario de Monterrey, N.L., México, desde enero de 1983 se han aplicado 32 halos cefálicos en pacientes con deformidades de la columna verteral. El objetivo de este trabajo es comentar la técnica empleada en la aplicación del halo; mencionar los casos en que se ha utilizado, así como dar a conocer el alto porcentaje de seguridad en su aplicación y la baja incidencia de complicaciones.