Teresa Gómez García

Kinetic model for the esterification of oleic acid and cetyl alcohol using an immobilized lipase as catalyst

A kinetic model has been developed for the enzymatic esterification of oleic acid with cetyl alcohol catalyzed by a Candida antarctica immobilized lipase. The model is based on an ordered reaction mechanism with two reactants and two products. The reaction mechanism includes two groups of steps. The first group consists of reaction steps, while the second is formed by the inhibition steps involving enzymatic complexes or free lipase. The reaction has been carried out at a laboratory scale in a stirred tank reactor. The operating conditions have been fixed so that the system operates in liquid phase and can be considered as pseudohomogeneous with regard to the flow conditions. Depending on the pressure level, the reaction can be considered reversible or irreversible. In both cases the kinetic model has been proposed to cover a range of temperatures between 70 and 80°C, an initial concentration of immobilized lipase between 3 and 7 wt%, and considering different molar ratios of reactants. Parameter estimation was carried out by using computer programmes based on numerical calculation algorithms. Discrimination of parameters was carried out by considering their physical meaning and the adequate prediction of the experimental results. Finally, the validity of the proposed models was quantified by means of residual analysis and simulation experiments.

Psychiatric Comorbidity in Asthma Patients. Associated Factors

Objective. To study the prevalence of anxiety and depression in patients with asthma and to identify associated factors. Material and methods. The study was based on individual data of subjects aged ≥18 years drawn from the 2006 Spanish National Health Survey. We identified asthmatic individuals through a specific questionnaire. Presence of depression or anxiety was assessed using the following questions: (1) “Have you suffered depression or anxiety over the previous 12 months?” (2) “Has your medical doctor confirmed the diagnosis?” (3) “Have you consumed antidepressants prescribed by your physician over the last 2 weeks?” (4) “Have you consumed anxiolytics prescribed by your physician over the last 2 weeks?” Those who answered yes to questions 1, 2, and 3 or to all questions were considered “Depression sufferers,” those who answered yes to questions 1, 2, and 4 were considered “Anxiety sufferers.” We analyzed sociodemographic characteristics and health-related variables. Results. Of the 28,966 subjects included in the study, 1650 were classified as asthmatic (5.6%). The prevalence of anxiety was 9.7% among people with asthma and 6.6% among those without the disease (p < .01). After multivariate adjustment the probability of a subject suffering anxiety was 1.27 (95% CI 1.08–1.49) higher among those with asthma than among those without. Independent and significantly associated variables with anxiety among asthmatic patients were older age, concomitant comorbidities, and visits to general practitioner in the last 4 weeks. The prevalence of depression was 9% among asthmatics and 5.5% among those without the disease (p < .05). The multivariate adjustment revealed that suffering depression was associated with suffering asthma (adjusted OR 1.39, 95% CI 1.18–1.64). Variables associated with depression among asthmatic patients were female sex, older age, worse self-related health, concomitant comorbidities, abstemious individuals, and the need for attendance on emergency room in the last year. Conclusions. Suffering anxiety or depression is associated with suffering asthma. Associated variables with anxiety or depression among asthmatic patients include older age and concomitant comorbidities.

Kinetic modelling of the synthesis of 2-hydroxy-5-hexenyl 2-chlorobutyrate ester by an immobilised lipase

An esterification process was developed for the direct synthesis of 2-hydroxy-5-hexenyl 2-chlorobutyrate ester from 2-chlorobutyric acid by using the epoxide 1,2-epoxy-5-hexene and Mucor miehei immobilised lipase as the biocatalyst in a batch reactor. The effect of temperature, catalyst concentration, and substrate and product concentration has been studied. An ordered Bi Uni enzymatic mechanism with competitive inhibition by the epoxide and acid has been proposed. The corresponding kinetic parameters were calculated by non-linear regression. Activation energy shows a value of 8.04kcal/mol. The thermodynamic parameters of the process, enthalpy and entropy, were 15.4kcal/mol and 45cal/mol, respectively.

Comorbilidades de la EPOC

Resumen Las comorbilidades asociadas a la enfermedad pulmonar obstructiva cronica (EPOC) son el conjunto de alteraciones y trastornos que pueden encontrarse asociados, por uno u otro motivo, a esta enfermedad. Pueden ser causales (otras enfermedades de las que tambien el tabaquismo es la causa, como la cardiopatia isquemica o el cancer de pulmon), una complicacion (una hipertension pulmonar o una insuficiencia cardiaca), una coincidencia (un trastorno relacionado con la edad avanzada como la hipertension arterial, la diabetes mellitus, la depresion o la artrosis) o una intercurrencia (un proceso agudo, generalmente limitado en el tiempo, como una infeccion respiratoria). De todas ellas, las que se asocian a la EPOC con una mayor frecuencia son la hipertension arterial, la diabetes mellitus, las infecciones, el cancer y las enfermedades cardiovasculares. Las comorbilidades en la EPOC no solo contribuyen a aumentar la repercusion social y el coste anual de la enfermedad, sino que tambien constituyen un factor pronostico de mortalidad en los pacientes en los que existen. De hecho, se ha demostrado que, ademas de la insuficiencia respiratoria, la cardiopatia isquemica y las neoplasias son causas frecuentes por las que fallecen los individuos que tienen una EPOC. En este capitulo se abordan las comorbilidades de la EPOC mas relevantes por su frecuencia, por la repercusion que producen o por la mortalidad que originan. Aunque no se conoce con exactitud, el mecanismo comun a todas ellas puede ser la inflamacion sistemica y sus mediadores, que desempenan un papel importante en su patogenia.

Prevalence of anxiety and depression among chronic bronchitis patients and the associated factors

Background and objective:u2003 Patients with COPD, including those with chronic bronchitis (CB), have a high risk of suffering from psychiatric disorders. Although depression has always received greater attention in these patients, most of the published studies have been of poor methodological quality. Anxiety has received less attention than depression among COPD patients. The aim of this study was to assess the prevalence of anxiety and depression among patients with CB and to identify associated factors.

Ventilación no invasiva

The advent of non-invasive mechanical ventilation (NIMV) has radically changed the management of acute and chronic respiratory failure. Over the last few years, the number of possible applications of NIMV has progressively increased, both in the hospital and extrahospital setting. NIMV is now used in all hospitals and resident physicians currently receive specific training -nonexistent until a few years ago- in this modality. It falls to all of us to push forward the clinical and scientific advances represented by the development of NIMV, by promoting the events that accompany better knowledge of the physiopathological bases of ventilation and of its continuous applications in daily clinical practice and by perfecting the elements required for the correct application of this technique. The present review aims to provide a broad overview of NIMV, from the most theoretical knowledge (the physiopathology of NIMV) to the most practical skills (recognition of patient-ventilator asynchrony). Through this progression from the complex to the most basic, or from the basics to the most complex, depending on the perspective taken, we aim to provide deeper knowledge of the concepts required to understand the technical functioning of the ventilator, describing its distinct modes and parameters and the abilities that must be developed for the correct indication, use and monitoring of the technique. We provide a final reflection on other forms of respiratory support that can be offered to patients with ventilatory failure.Resumen La llegada de la ventilacion mecanica no invasiva (VMNI) ha condicionado un cambio radical en el manejo de la insuficiencia respiratoria aguda y cronica. A lo largo de los ultimos anos, hemos asistido al incremento progresivo en el numero de aplicaciones posibles de la VMNI, tanto en el ambito hospitalario como extrahospitalario. Su uso se ha universalizado en todos los hospitales y en la actualidad los residentes del siglo XXI reciben una formacion especifica que no existia hasa hace solo unos anos. Es deber de todos nosotros encabezar el avance asistencial y cientifico que ha supuesto el desarrollo de la VMNI, liderando los acontecimientos que acompanen al mejor conocimiento de las bases fisiopatologicas de la ventilacion, de sus continuas aplicaciones en la practica clinica diaria y del perfeccionamiento de los elementos necesarios para una correcta aplicacion de la tecnica. En la presente revision se pretende efectuar un recorrido global en el procedimiento de la VMNI, desde los conocimientos mas teoricos –fisiopatologia de la VMNI–, hasta las habilidades mas practicas –reconocimiento de las asincronias paciente-ventilador–. En este progreso de lo complejo a lo basico o de lo basico a lo complejo, segun se mire, intentaremos profundizar en las nociones necesarias para comprender el propio funcionamiento tecnico del ventilador, adentrandonos en los diferentes modos y parametros, y exponiendo las capacidades que debemos desarrollar para la correcta indicacion, uso y monitorizacion de la tecnica, con una ultima reflexion acerca de otras ayudas respiratorias que podemos ofrecer a pacientes con fracaso ventilatorio.

Hacia un tratamiento individualizado e integrado del paciente con EPOC

The concept of chronic obstructive pulmonary disease (COPD) is broad and generic. In clinical practice and research, the definition of COPD is based on the extent of airflow obstruction measured through spirometry. However, it is currently known that this disease encompasses a complex variety of cellular, anatomical, functional and clinical manifestations that could allow distinct COPD phenotypes to be defined. Moreover, the severity of COPD depends not only on pulmonary function evaluated through spirometry but also on other variables such as clinical symptoms, exacerbations and the presence of complications and comorbidities, which contribute to distinguishing among the distinct phenotypes. Phenotypic heterogeneity may affect treatment response and the clinical course of the disease. COPD is, therefore, a complex entity requiring comprehensive and multidimensional evaluation to establish more personalized and integrated treatment.

Kinetic modelling of enzymatic chiral resolution of (±)2-methyl butyric acid

Abstract A kinetic study of 2-methyl butyric acid esterification reaction catalyzed by immobilized lipase (from Candida antarctica ) has been made in a range of 62 – 78°C temperature. The kinetic characteristics observed in the chiral resolution of (±) 2-methyl butyric acid by esterification reaction with n-octanol were found to conform to an ordered bi-bi mechanism with competitive inhibition by reactants and products. According to the mechanism maximum reaction rate, Michaelis Menten constants and inhibition constants were determined. The results suggest that lipase should recognize the chirality of 2-methyl butyric acid molecule in the binding process to the active site of lipase. A good quality of fit was observed by fitting experimental rate data to the kinetic model.

RevisiónTerapias ventilatorias domiciliarias en el síndrome de apnea-hipopnea del sueñoHome Ventilation Therapy in Obstructive Sleep Apnea-Hypopnea Syndrome

Obstructive sleep apnea-hypopnea is a highly prevalent disease that is often underdiagnosed at present. It has a significant economic and social welfare impact, accounting for a large part of the resources assigned to home respiratory therapies. As part of the 2014 SEPAR Year of the Chronic Patient and Domiciliary Respiratory Care sponsored by the Spanish Society of Pulmonology and Thoracic Surgery, this article reviews the most recent publications on the indications and controversial issues in the treatment of sleep apnea, the latest evidence for indication of various positive pressure devices, and adjustment modes, ranging from the use of empirical formulae or mathematical estimations to modern auto-CPAP equipment, while not forgetting the gold standard of manual titration. Emphasis is placed on the need for monitoring required by patients to ensure treatment adherence and compliance. Finally, other therapies that are not the object of this article are briefly reviewed.Obstructive sleep apnea-hypopnea is a highly prevalent disease that is often underdiagnosed at present. It has a significant economic and social welfare impact, accounting for a large part of the resources assigned to home respiratory therapies. As part of the 2014 SEPAR Year of the Chronic Patient and Domiciliary Respiratory Care sponsored by the Spanish Society of Pulmonology and Thoracic Surgery, this article reviews the most recent publications on the indications and controversial issues in the treatment of sleep apnea, the latest evidence for indication of various positive pressure devices, and adjustment modes, ranging from the use of empirical formulae or mathematical estimations to modern auto-CPAP equipment, while not forgetting the gold standard of manual titration. Emphasis is placed on the need for monitoring required by patients to ensure treatment adherence and compliance. Finally, other therapies that are not the object of this article are briefly reviewed.

Circulación pulmonar: ¿qué ha aportado el año 2010?

Resumen Tanto en el ambito de la enfermedad tromboembolica como en el de la hipertension pulmonar el ano 2010 ha sido prodigo en publicaciones de interes. Respecto a la primera, algunos datos han ayudado a conocer mejor los factores asociados a mayor riesgo de presentarla, como viajes largos o ciertos polimorfismos. Desde el punto de vista del diagnostico, han aparecido nuevas recomendaciones, con mayor protagonismo de la angio-TC. La resonancia magnetica tambien va ganando terreno. Establecer con mayor certeza el riesgo del paciente es uno de los objetivos de las nuevas guias de la Sociedad Europea de Cardiologia, que sustituyen algunos terminos como masivo o submasivo por otros como alto o bajo riesgo. Respecto al tratamiento, se aboga por mantener de forma indefinida la anticoagulacion en casos de tromboembolismo pulmonar idiopatico. Los nuevos farmacos, como rivaroxaban, dabigatran o indraparinux, empiezan a acumular evidencias acerca de su eficacia. Respecto de la hipertension pulmonar, el tabaco parece desempenar un cierto papel como factor de riesgo. Los resultados de algunos registros no parecen ser muy alentadores en cuanto a la mejoria de la supervivencia con los nuevos tratamientos. Se comienza a conocer algo mas el papel de la inflamacion en la patogenia de la enfermedad y un estudio espanol refuerza el papel de la prueba de 6 min en la evaluacion del paciente. Algunos farmacos empiezan a asomar en la literatura cientifica. El imatinib es prometedor pero seguramente solo en algunos pacientes, riociguat muestra buenos resultados y treprostinil inhalado surge como nueva opcion.In both thromboembolic disease and pulmonary hypertension, 2010 has been a prodigious year for interesting publications. Some data have helped to elucidate the factors associated with a greater risk of thromboembolic disease, such as long journeys and certain polymorphisms. New recommendations on diagnosis have been made, giving a greater role to computed tomography angiography. Magnetic resonance imaging is also gaining ground. More accurate risk evaluation is one of the objectives of the new guidelines of the European Society of Cardiology, which substitute some terms such as massive or submassive for high- and low-risk. Maintaining anticoagulation indefinitely in idiopathic pulmonary thromboembolism is recommended. Evidence on the efficacy of new drugs such as rivaroxaban, dabigatran and indraparinux is beginning to appear. In pulmonary hypertension, smoking seems to play a role as a risk factor. Some registries indicate that new treatments have not improved survival. Greater knowledge has been gained of the role of inflammation in the pathogenesis of the disease and a Spanish study supports the role of the 6-minute walk test in patient evaluation. Some drugs are highlighted in the literature. Imatinib is promising but probably only in some patients. Riociguat provides good results and inhaled treprostinil has emerged as a new option.