Tight and selective caging of chloride ions by a pseudopeptidic host.

The selective molecular recognition of chloride versus similar anions is a continuous challenge in supramolecular chemistry. We have designed and prepared a simple pseudopeptidic cage (1 a) that defines a cavity suitable for the tight encapsulation of chloride. The interaction of the protonated form of 1 a with different inorganic anions was studied in solution by (1)H NMR spectroscopy and ESI-MS, and in the solid state by X-ray diffraction. The solution binding data showed that the association constants of 1 a to chloride are more than two orders of magnitude higher than to any other tested inorganic anion. Remarkably, 1 a displayed a high selectivity for chloride over other closely related halides such as bromide (selectivity=111), iodide (selectivity=719), and fluoride (selectivity >1000). Binding experiments ((1)H NMR spectroscopy and ESI-MS) suggested that 1 a has a high-affinity (inner) binding site and an additional low-affinity (external) binding site. The supramolecular complexes with F(-), Cl(-), and Br(-) have been also characterized by the X-ray diffraction of the corresponding [1 a⋅nHX] crystalline salts. The structural data show that the chloride anion is tightly encapsulated within the host, in a binding site defined by a very symmetric array of electrostatic H-bonds. For the fluoride salt, the size of the cage cavity is too large and is occupied by a water molecule, which fits inside the cage efficiently competing with F(-). In the case of the bigger bromide, the mismatch of the anion inside the cage caused a geometrical distortion of the host and thus a large energetic penalty for the interaction. This minimalistic pseudopeptidic host represents a unique example of the construction of a simple well-defined binding pocket that allows the highly selective molecular recognition of a challenging substrate.

Tuning chloride binding, encapsulation, and transport by peripheral substitution of pseudopeptidic tripodal small cages.

A highly efficient synthesis of small pseudopeptidic cages from simple precursors has been achieved by the triple S(N)2 reaction between tripodal tris(amido amines) and several 1,3,5-tris(bromomethyl)benzene electrophiles. The success of the macrobicyclization strongly depends on the central triamine scaffold, which dictates the correct preorganization of the intermediates. The chloride binding properties of the protonated pseudopeptidic cages have been studied in the solid state (by X-ray diffraction) as well as in solution (by NMR spectroscopy and ESI-MS) and in the gas phase (by collision-induced dissociation (CID)-MS). The crystal structure of the HCl salts of several cages show a chloride partially or completely caged within the cavity of the macrobicycle. Both the amino acid side chain and the substitution at the aromatic tripodal ring have an effect on the chloride binding ability. The cages derived from the 1,3,5-benzene moiety show low affinity, whereas the triple substitution in the ring (either with Me or Et) increases the chloride binding by one order of magnitude. Besides, the cages derived from aliphatic amino acids display a stronger interaction than those derived from phenylalanine. The basis for the different mode of binding depending on the receptor structure is proposed according to the structural data (X-ray and NMR spectroscopy). Finally, the transport of the chloride anion through lipid bilayers has been studied for selected cages. Despite the important differences in the chloride binding, the transport properties are better correlated with the lipophilicity of the molecules. Therefore, the pseudopeptidic cages sharing the same binding motif for chloride rendered very different interaction and transport properties depending on the peripheral substitution.

Comparative study of Legiolert with ISO 11731-1998 standard method-conclusions from a Public Health Laboratory.

BACKGROUND: Legionella pneumophila (L. pneumophila) is responsible for 96% of Legionnaires' disease (LD) and 10% of all worldwide pneumonia cases. Legiolert™, a liquid culture method for most probable number (MPN) enumeration of L. pneumophila, was developed by IDEXX Laboratories. The method detects all serogroups of L. pneumophila in potable and non-potable water samples. OBJECTIVE: The goal of this study is to establish that Legiolert is a suitable alternative method to meet testing requirements in Spain for the enumeration of Legionella in water samples. METHODOLOGY: The laboratory analyzed 118 environmental water samples from the Barcelona region (56 potable and 62 non-potable) in parallel by the Standard method for detection and enumeration of Legionella (ISO 11731:1998) and by Legiolert. Comparison of the recovery of the alternative method (Legiolert) and the Standard was made using ISO 17994:2014 and McNemar's binomial test statistical methods. RESULTS: 44 samples were positive for Legionella (36 potable and 8 non-potable). Legiolert and the Standard method detected a similar percentage of positive samples, with Legiolert being slightly higher (31 vs 30%) and detecting higher concentrations of Legionella within the samples. ISO 17994:2014 analysis of the potable water samples found Legiolert was more sensitive than the Standard at detecting Legionella, even when complete Legionella species (L. spp.) results were considered for both methods. The two methods also demonstrated equivalent detection of L. spp. according to the McNemar's test. The comparison is significantly more in favor of Legiolert when only L. pneumophila results are considered. Each confirmation run with material extracted from positive Legiolert wells contained L. pneumophila, giving the method a specificity of 100%. Although statistical results for non-potable waters are not included because of the low number of samples, the two methods trended towards equivalence. CONCLUSIONS: Relative to the Standard method, Legiolert has a greater sensitivity and selectivity, and appears to have higher recovery for L. pneumophila, and equivalent recovery when L. spp. is included in the comparison. Legiolert also has high specificity. The procedural advantages of Legiolert allow laboratories to save on resources, costs, and time and consequently to test more frequently. In conclusion, the study finds IDEXX Legiolert a suitable alternative to ISO 11731:1998.

Effect of the application of the "Patient blood management" programme on the approach to elective hip and knee arthroplasties. / Efecto de la aplicación del programa Patient blood management en el abordaje de las artroplastias de cadera y rodilla programada.

BACKGROUND AND OBJECTIVES: The "Patient Blood Management" (PBM) programmes have demonstrated their value in the continuous improvement of care practice, due to continuous systematic reviewing of results and their dynamic and multidisciplinary updating in accordance with new clinical evidence. Our goal is to demonstrate the effectiveness of simple protocols, applicable in second level hospitals. PATIENTS AND METHODS: 702 patients undergoing scheduled arthroplasty from 2011 to 2018 were retrospectively analysed. During this period, the evolution of transfusion rates and anaemia and bleeding management were recorded in the patients' computerised clinical histories. RESULTS: Stages and transfusion rates were: Year 2011-2012, "Universal self-donation programme": 62.4%; year 2013, "Optimization of preoperative haemoglobin and universal self-donation withdrawal", 22.5%; year 2015, "Stopping the use of cell-savers and drains", 13.2%; and year 2017, "Introduction of routine tranexamic acid", 3.6%. A significant reduction in the transfusion rate and volume (P<.001) and the average hospital stay (8 to 6 days) (P<.001) was achieved. In multivariate models, transfused patients have a .5-day stay and there is a trend towards a reduction in complications, being fewer in patients receiving tranexamic acid (OR .44). CONCLUSION: A simple progressive and multidisciplinary PBM programme, with continued re-evaluation, has allowed a reduction in transfusion rates and average hospital stay.

El terapeuta ocupacional como acompañante terapéutico en el ámbito de la salud mental comunitaria / No disponible

Lo que se explica en este artículo, corresponde a una visión concreta de lo que significa el acompañamiento a personas con una enfermedad mental severa. Esta visión y orientación está basada en la teoría psicodinámica. Se ha teorizado una manera de trabajar específica del terapeuta ocupacional dentro de la atención comunitaria en el ámbito de la salud mental. La intervención domiciliaria que se hace desde la Terapia Ocupacional como acompañante terapéutico está basada en el uso terapéutico del vínculo entre terapeuta y persona, y entre la persona y su comunidad. Dándole a la persona un lugar de protagonismo en la intervención, fomentando la autonomía, la responsabilidad y la creación de un proyecto de vida saludable. Respecto al terapeuta como profesional, se analiza las dificultades con las que se puede encontrar a nivel emocional con la persona a la cual atiende desde una perspectiva transferencial y contratransferencial. Así como la utilidad del uso terapéutico del encuadre que proporciona a la persona coherencia, seguridad y límites

What is explained in this article corresponds to a precise vision of what it means to accompany people with severe mental illness. This view is base on psychodynamic theory. A specific Occupational Therapy way of working in a mental health community setting has been theorized. Home interventions carried out from Occupational Therapy as a therapeutic companion are based on the therapeutic use of the bond between the professional and the person, and between the professional and the community. Offering the client a leading role in the intervention, promoting autonomy, responsibility and the possibility to create a healthy life project. Regarding the therapist as a professional, the emotional issues that may appear, both at a transferential and countertransference level are analysed. As well as the benefits of using a therapeutic setting which offers the client coherence, security and limits

Copper(II) complexes of bis(amino amide) ligands: effect of changes in the amino acid residue.

A family of ligands derived from bis(amino amides) containing aliphatic spacers has been prepared, and their protonation and stability constants for the formation of Cu(2+) complexes have been determined potentiometrically. Important differences are associated to both the length of the aliphatic spacer and the nature of the side chains derived from the amino acid. In general, ligands containing aliphatic side chains display higher basicities as well as stability constants with Cu(2+). In the same way, basicities and stability constants tend to increase when decreasing the steric hindrance caused by the corresponding side-chain. FT-IR, UV-vis and ESI-MS were used for analyzing the complex species detected in the speciation diagram. UV-vis studies showed the presence of different coordination environments for the copper(II) complexes. Complexes with different stoichiometries can be formed in some instances. This was clearly highlighted with the help of ESI-MS experiments.

Efecto de la aplicación del programa Patient blood management en el abordaje de las artroplastias de cadera y rodilla programada / Effect of the application of the "Patient blood management" programme on the approach to elective hip and knee arthroplasties

ANTECEDENTES Y OBJETIVOS: Los programas de Patient blood management (PBM) han demostrado su valor en la mejora continua de la práctica asistencial, gracias a la revisión sistemática de resultados y a su actualización dinámica y multidisciplinar, de acuerdo con las nuevas evidencias clínicas. Nuestro objetivo es demostrar la efectividad y seguridad de protocolos sencillos, aplicables en hospitales de segundo nivel. PACIENTES Y MÉTODOS: Se han analizado retrospectivamente 702 pacientes intervenidos de artroplastia programada desde 2011 hasta 2018. Durante este periodo se ha registrado en la historia clínica de los pacientes la evolución transfusional y el manejo de la anemia y el sangrado. RESULTADOS: Fases y tasas de transfusión: año 2011-2012 «Programa autodonación universal»: 62,4%; año 2013 «inicio optimización de hemoglobina preoperatoria y retirada autodonación universal» 22,5%; año 2015 «suspensión del uso de recuperadores y los drenajes» 13,2%; y año 2017 «inicio de uso de ácido tranexámico (ATX)» 3,6%. Se ha conseguido una reducción significativa de la tasa y el número de concentrados de hematíes transfundidos (p < 0,001) y de la estancia media hospitalaria (de 8 a 6 días) (p < 0,001). En los modelos multivariantes los pacientes transfundidos tienen 0,5 días más de estancia y se observa una tendencia a la reducción en complicaciones, siendo menores en los pacientes que reciben ATX (OR 0,44). CONCLUSIÓN: Un programa PBM sencillo, progresivo y multidisciplinar, con reevaluación continuada, ha permitido reducir la transfusión y la estancia media hospitalaria en un hospital de segundo nivel

BACKGROUND AND OBJECTIVES: The "Patient Blood Management" (PBM) programmes have demonstrated their value in the continuous improvement of care practice, due to continuous systematic reviewing of results and their dynamic and multidisciplinary updating in accordance with new clinical evidence. Our goal is to demonstrate the effectiveness of simple protocols, applicable in second level hospitals. PATIENTS AND METHODS: 702 patients undergoing scheduled arthroplasty from 2011 to 2018 were retrospectively analysed. During this period, the evolution of transfusion rates and anaemia and bleeding management were recorded in the patients' computerised clinical histories. RESULTS: Stages and transfusion rates were: Year 2011-2012, "Universal self-donation programme": 62.4%; year 2013, "Optimization of preoperative haemoglobin and universal self-donation withdrawal", 22.5%; year 2015, "Stopping the use of cell-savers and drains", 13.2%; and year 2017, "Introduction of routine tranexamic acid", 3.6%. A significant reduction in the transfusion rate and volume (P<.001) and the average hospital stay (8 to 6 days) (P<.001) was achieved. In multivariate models, transfused patients have a .5-day stay and there is a trend towards a reduction in complications, being fewer in patients receiving tranexamic acid (OR .44). CONCLUSION: A simple progressive and multidisciplinary PBM programme, with continued re-evaluation, has allowed a reduction in transfusion rates and average hospital stay