Electrochemical disinfection of secondary wastewater treatment plant (WWTP) effluent

In this work the electrochemical disinfection of the effluent of a secondary wastewater treatment plant is investigated. In the experimental work, performed on-site with real effluents of the WWTP located in Vuelta Ostrera (Cantabria, Spain), boron-doped diamond (BDD) electrodes were employed. The initial concentration of E. coli in the effluent of the WWTP varied in the range 1.3 x 10⁴-5.2 x 10⁵ cfu/mL. The influence of two operation variables on the kinetics of E. coli deactivation was investigated: i) The applied current density was varied in the range J=40-120 mA/cm², showing first order kinetics, and linear dependency of the apparent kinetic constant with the applied current density; and ii) the chloride concentration was varied in the range 60-1,050 mg/L, showing that increasing chloride content also enhanced the kinetics of the E. coli deactivation. The latter parameter is particularly important in coastal areas, as in the case of the present study. The formation of disinfection by-products (DBPs) was followed by measuring the content of trihalomethanes (THMs) that nevertheless was maintained below 100 μg/L, so it can be concluded that the formation of DBPs is not a disadvantage of electrochemical disinfection of secondary effluents of WWTP.

Effective potentials of dissipative hard spheres in granular matter

We present an experimental study of the spatial correlations of a quasi-two-dimensional dissipative gas kept in a non-static steady state via vertical shaking. From high temporal resolution images we obtain the Pair Distribution Function (PDF) for granular species with different restitution coefficients. Effective potentials for the interparticle interaction are extracted using the Ornstein-Zernike equation with the Percus-Yevick closure. From both the PDFs and the corresponding effective potentials, we find a clear increase of the spatial correlation at contact with the decreasing values of the restitution coefficient.

Neutropenia, thrombocytopenia and hepatic injury associated with dexketoprofen trometamol therapy in a previously healthy 35-year-old woman

This case report describes a previously healthy 35-year-old woman, with an episode of fever, neutropenia, thrombocytopenia and elevation of biochemical markers of liver injury, 10 days after beginning drug therapy with dexketoprofen trometamol. Infectious and autoimmune causes of neutropenia, and viral or autoimmune hepatitis were excluded. The resolution following withdrawal of dexketoprofen trometamol confirms the possibility of an adverse drug reaction.

Coordinated induction of drug transporters and phase I and II metabolism in human liver slices

Although regulation of phase I drug metabolism in human liver is relatively well studied, the regulation of phase II enzymes and of drug transporters is incompletely characterized. Therefore, we used human liver slices to investigate the PXR, CAR and AhR-mediated induction of drug transporters and phase I and II metabolic enzymes. Precision-cut human liver slices were incubated for 5 or 24h with prototypical inducers: phenobarbital (PB) (50 microM) for CAR, beta-naphthoflavone (BNF) (25 microM) for AhR, and rifampicin (RIF) (10 microM) for PXR, and gene expression of the phase I enzymes CYP1A1, 1A2, 3A4, 3A5, 2B6, 2A6, the phase II enzymes UGT1A1 and 1A6, and the transporters MRP2, MDR1, BSEP, NTCP and OATP8 was measured. BNF induced CYP1A1, UGT1A1 and UGT1A6 and MRP2, NTCP and MDR1. RIF induced CYP3A4, 3A5, 2B6, 2A6, UGT1A1, UGT1A6 and BSEP, MRP2 and MDR1 and slightly downregulated OATP8. PB induced CYP3A4, 3A5, 2B6 and 2A6, UGT1A1 and all transporters. Large interindividual differences were found with respect to the level of induction. Enzyme activity of CYP3A4, measured by testosterone metabolism, was increased after 24h by RIF. 7-Ethoxycoumarin O-deethylation activity, mediated predominantly by CYP 1A1/1A2 but also by other CYPs, was increased after 24h with PB. We have shown that regulation of all phases of the (in)activation of a drug via the CAR, AhR and the PXR pathways can be studied in human liver slices. The concomitant induction of metabolic enzymes and transporters shows that also in the human liver transporters and metabolic enzymes are regulated coordinately.

Decline of pesticide residues from barley to malt

The fate of dinitroaniline herbicides (pendimethalin and trifluralin), organophosphous insecticides (fenitrothion and malathion), and pyrimidine (nuarimol) and triazole (myclobutanil and propiconazole) fungicides from barley to malt was determined. Several samples for residue analysis were taken after each stage of malting (steeping, germination and kilning). Pesticide residue analysis was carried out by GC/ITMS in selected ion monitoring mode. Pesticides decline along the process, although in different proportions. The carryover of residues after steeping was 45-85%. A good correlation (r > 0.92) was observed between percentages removed after steeping and the P(OW) values of pesticides. The amount remaining after malting ranged from 13 to 51% for fenitrothion and nuarimol, respectively. Steeping was the most important stage in the removal of pesticide residues (52%) followed by germination (25%), and kilning (drying and curing, 23%). During malt storage (3 months) the fall in pesticide residues was not significant. Applying the standard first-order kinetics equation (r > 0.95), the half-lives obtained for the pesticides during malt storage varied from 244 to 1533 days for myclobutanil and nuarimol, respectively.

Breakfast, plasma glucose and beta-hydroxybutyrate, body mass index and academic performance in children from Extremadura, Spain

OBJECTIVES

Nutritional aspects of breakfast, plasma levels of glucose and beta-hydroxybutyrate, body mass index and academic performance have been studied in urban and rural children (Extremadura, Spain).

METHODS

Representative samples of schoolchildren (3 to 12 years old, random cluster-sampling in schools).

RESULTS

Children's mean caloric intake with breakfast was 331 kcal. Rural population ingested more carbohydrates (46,9 +/- 12,3% versus 43,3 +/- 13,2% of the total caloric intake) and fewer lipids (40,5 +/- 11,8% versus 43,9 +/- 12,8% of the total caloric intake) than the urban population. Academic performance was significantly better in the children inhabiting the rural zone than in those of the urban zone. The glycaemia was higher in the urban than in the rural children, and that the contrary was the case for the beta-hydroxybutyrate values. Neither glucose nor beta-hydroxybutyrate levels were correlated with academic performance values. BMI was significantly increased in the urban versus rural children.

CONCLUSION

The present results emphasize the importance of breakfast and life style in the weight and the academic performance of children.

Gastrojejunal anastomotic stricture after Roux-en-Y gastric bypass: ambulatory management with the Savary-Gilliard dilator

BACKGROUND

Roux-en-Y gastric bypass (RYGBP) is currently one of the most frequently performed procedures for the surgical treatment of morbid obesity. The success of this procedure's restrictive component requires a small gastrojejunostomy (GJ), which occasionally results in stenosis. The treatment of choice for this complication is balloon dilation. This study aimed to evaluate the feasibility and safety of ambulatory management for stenosis of the GJ using endoscopically guided Savary-Gilliard dilators.

METHODS

Between January 1998 and October 2003, 769 patients underwent RYGBP. The mean age of these patients was 38 +/- 12 years, and their mean body mass index (BMI) was 43 +/- 6 kg/m2. Of these 769 patients, 520 (68%) underwent open surgery and 249 (32%) underwent laparoscopic RYGBP. Patients suspected of GJ stenosis were referred for upper gastrointestinal endoscopy. Those who presented with stenosis were managed endoscopically with Savary-Gilliard dilators.

RESULTS

Stenosis at the GJ was confirmed in 53 patients (6.9%). A total of 71 dilations were performed for these patients, resulting in a mean of 1.3 dilations per patient. One dilation was needed for 41 patients (75.5%), two dilations for 9 patients (16.9%), three dilations for 3 patients (5.7%), and four dilations 1 patient (1.9%). The patients subjected to open RYGBP required a mean of 1.57 dilations, and those who had laparoscopic RYGBP required mean of 1.08 dilations. The mean time for the first dilation was 51 +/- 28 days after surgery (range, 20-178 days). All the dilations were performed in ambulatory settings. One patient (1.9%) was admitted after GJ dilation for pain. He was discharged without symptoms after 2 days with no need for invasive procedures.

CONCLUSIONS

The management and treatment of GJ stenosis after RYGBP can be effectively accomplished in ambulatory settings using endoscopically guided Savary-Gilliard dilators, with good and safe results.

Antioxidant status in patients with sleep apnoea and impact of continuous positive airway pressure treatment

The episodes of hypoxia/re-oxygenation associated with the respiratory disturbances observed in patients with obstructive sleep apnoea syndrome (OSAS) may induce the generation of oxygen free radicals. Indeed, several studies suggest that OSAS is associated with oxidative stress. The present study tested the hypothesis that patients with OSAS have an alteration in antioxidant defences. The plasma levels of total antioxidant status (TAS), glutathione peroxidase (GPX), gamma-glutamyltransferase (GGT), vitamins A, E, B12 and folate, and homocysteine were determined in 47 patients with OSAS and 37 healthy subjects. Of these, 27 patients who used continuous positive airway pressure (CPAP) for >4 h.night-1 were re-examined 12 months later. Patients with OSAS had lower TAS (1.4+/-0.16 versus 1.50+/-0.10 mmol.L-1), vitamin A (64+/-19 versus 74+/-17 microg.dL-1) and vitamin E levels (1,525+/-499 versus 1,774+/-503 microg.dL-1), and increased values of GGT (42+/-22 versus 32+/-16 U.L-1) than controls. There was no difference between groups in GPX, homocysteine, vitamin B12 and folate plasma levels. CPAP treatment normalised the levels of TAS (1.50+/-0.13 mmol.L-1) and the activity of GGT (30+/-14 U.L-1) without any influence on vitamins levels. In conclusion, the results indicate that patients with obstructive sleep apnoea syndrome have a decreased antioxidant capacity that is partially reversed by continuous positive airway pressure treatment.

Determination of pollution trends in an abandoned mining site by application of a multivariate statistical analysis to heavy metals fractionation using SM&T-SES

The mobility, availability and persistence of Heavy Metals (HMs), As, Cd, Cu, Ni, Pb and Zn, in contaminated soils of a former abandoned mining area were evaluated by means of a sequential extraction scheme (SES) and applying a multivariate statistical analysis to the obtained data. Chemical partitioning of HMs in each sample was determined in four fractions (acid-soluble, reducible, oxidable and residual) following the Standard Measurements and Testing (SM&T) SES, formerly BCR-SES. Statistical evaluation of results by pattern recognition techniques allowed identification of groups of samples with similar characteristics and observations of correlations between variables, determining the pollution trends and distribution of HMs within the studied area. Typical metal-fraction association and metal availability characteristics of heavy metals have been depicted. The obtained results indicate an urgent need to attenuate the hazard in that area posed by high concentrations of toxic metals, which exceed the limits specified by different European legislations on soil reclamation.

[Diagnosis and assessment of therapeutic response of bone metastases by bone scintigraphy and PET study]

Nuclear medicine plays an important role in staging and evaluation of the initial extension and response to treatment of bone metastases. In order to accurately read Bone Scintigraphy (BS) and Positron Emission Tomography scan (PET) procedures, it is essential to understand the different behavior of these studies. We present a case report of a woman treated for breast cancer, with suspicion of recurrent disease due to increase of tumor markers. Initial BS showed non-conclusive findings, whereas PET study was consistent with a spread of bone metastases. The patient underwent both procedures again after a course of chemotherapy. Post-treatment BS showed progression of bone lesions, while PET showed good therapeutic response. The PET demonstrates lesions earlier and more effectively than the bone scintigraphy in the evaluation of the therapeutic response of bone metastases.

Cutaneous involvement in multiple myeloma: a clinicopathologic, immunohistochemical, and cytogenetic study of 8 cases

BACKGROUND

Specific cutaneous involvement in patients with multiple myeloma (MM) is very uncommon. It usually occurs in late stages of MM as a reflection of increased tumor cell burden. We studied 8 patients with cutaneous involvement of MM without underlying bony lesions and reviewed the literature on this rare dermatologic manifestation.

DESIGN

We were particularly interested in the clinical course of patients with MM and cutaneous metastases, including survival once metastases were detected and the possible influence of various forms of therapy. Our goal was also to identify the immunoglobulin and the light-chain type in these cases, with emphasis on any possible association between a particular immunoglobulin class and cutaneous involvement, as well as the histopathologic, immunohistochemical, and cytogenetic features of the neoplastic plasma cells involving the skin.

SETTING

University department of dermatology, university hospital, and private practice.

PATIENTS

Medical records and biopsy specimens from 8 patients with MM and specific cutaneous lesions were reviewed.

RESULTS

Cutaneous lesions consisted of multiple erythematous or violaceous nodules or plaques with a wide anatomical distribution. Histopathologically, 2 different patterns were identified: nodular and diffuse interstitial. Neoplastic plasma cells showed atypical features, and in 1 case they displayed a spindle shape, giving a sarcomatoid appearance to the lesion. Immunohistochemical studies demonstrated that neoplastic plasma cells were strongly positive for CD79a, CD138, and epithelial membrane antigen, and variably positive for VS38c and CD43. In each case the immunoglobulin profile and the light-chain type expression of the neoplastic cells were the same as those identified in the serum of the patients: 5 cases were IgA lambda; 2 cases were IgG kappa; and 1 case was IgA kappa. In cases 2, 3, and 4, polymerase chain reaction investigations revealed monoclonal rearrangement for IgH genes, whereas the investigations for human herpesvirus 8 and Epstein-Barr virus yielded negative results. Fluorescent in situ hybridization investigations in these 3 cases demonstrated that the cutaneous neoplastic plasma cells showed the deletion of the rb-1 (retinoblastoma) gene. Despite aggressive chemotherapy, all 8 patients died a few months after the development of cutaneous involvement.

CONCLUSIONS

In our series, there was a perfect correlation of immunoglobulin and light-chain type between the serum electrophoresis and the cutaneous plasma cells. Patients with MM showed a short survival once cutaneous metastases appeared independently of the therapy. The deletion the rb-1 gene may provide prognostically relevant information to identify a high-risk subset of patients with MM.

[Comparability between the ninth and tenth revisions of the International Classification of Diseases applied to coding causes of death in Spain]

OBJECTIVE

To analyze comparability between the ninth and tenth revisions of the International Classification of Diseases (ICD) applied to coding causes of death in Spain.

METHODS

According to the ninth and tenth revisions of the ICD, 80,084 statistical bulletins of mortality registered in 1999 were assigned the Basic Cause of Death. The statistical bulletins corresponded to the Autonomous Communities of Andalusia, Cantabria, Murcia, Navarre and the Basque Country, and the city of Barcelona. The underlying causes of death were classified into 17 groups. Simple correspondence, the Kappa index and the comparability ratio for major causes were calculated.

RESULTS

A total of 3.6% of deaths changed group due to an increase (36.4%) in infectious and parasitic diseases, mainly because of the inclusion of AIDS, and a corresponding decrease due to the exclusion of endocrine, nutritional and metabolic disorders. Furthermore, myelodysplastic syndrome was moved to the category of neoplasm. The group including nervous system diseases, eye and related diseases, and ear and mastoid apophysis diseases increased (14.7%) at the expense of mental and behavior disorders, due to the inclusion of senile and presenile organic psychosis. Poorly-defined entities increased (14.1%) due to the inclusion of cardiac arrest and its synonyms, together with heart failure, to the detriment of diseases of the vascular system. Diseases of the respiratory system increased (4.8%) due to the inclusion of respiratory failure, previously considered as a poorly defined cause. The correspondence for all causes was 96.4% and kappa's index was 94.9%

CONCLUSIONS

The introduction of ICD-10 affects the comparability of statistical series of mortality according to cause. The results of this study allow us to identify the main modifications and to quantify the changes in the major causes of mortality in Spain.

FDG-PET improves the management of patients with suspected recurrence of colorectal cancer

This study aims to assess the influence of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) detection of recurrent disease on the management of patients with colorectal cancer and suspected recurrence. One hundred and twenty patients with suspected recurrence were studied with FDG-PET. Fifty-eight patients were referred for FDG-PET because of the elevation of serum tumour markers. Thirty-one patients were referred because of inconclusive results of conventional imaging modalities. Twenty-five patients had known recurrence and were referred for pre-surgical assessment. Six patients were referred because of abdominal pain. A major management change was considered when, as a consequence of FDG-PET results, medical treatment was changed to surgical, or surgical to medical or to no treatment. A minor management change was considered when changes were made within a treatment modality. Of the 58 patients with elevated serum carcinoembryonic antigen (CEA), FDG-PET detected recurrence and led to a major management change in 34 (58%). Eighteen underwent curative surgery and 16 were treated with systemic therapy. Of the 31 patients evaluated because of inconclusive results of conventional imaging modalities, FDG-PET was positive for recurrence in 24 and negative in seven. A major management change took place in 14 patients (45%). Of the 25 patients evaluated to rule out other sites of disease before surgery, FDG-PET did not show any other site of recurrence in 13 (52%) and showed more lesions in the remaining patients. Major management change took place in eight patients (32%). Overall, in the 120 patients studied, FDG-PET resulted in major management changes in 58 (48%), minor changes in four (3%) and no change in 54 (45%). It can be concluded that FDG-PET has a significant impact on the management of patients with suspected recurrence of colorectal cancer. FDG-PET detection of recurrence frequently allows curative surgical intervention. The early identification of distant metastases may also facilitate the implementation of systemic treatment.

Vitamins and mineral intake in elderly people from Extremadura

To evaluate the vitamin and mineral consumption of a group of elderly people of the Comunidad of Extremadura. 122 subjects 62.5+/-5.3 years (64 women, 57 men) responded to a survey on their food intake the day before. The vitamin and mineral intake was calculated using a computer program from the University of Granada. We found no statistically significant differences by gender in the intake of the following vitamins: niacin (24.5+/-10.1 vs 25.6+/-9.7 mg/day), B1 (1.6+/-0.6 vs 1.7+/-0.6 mg/day), B6 (1.7+/-0.6 vs 1.8+/-0.5 mg/day), C (129.5+/-82.1 vs 158.1+/-97.6 mg/day), D (4.4+/-7.5 vs 3.8+/-6.5 microg/day), E (7.8+/-4.1 vs 8.1+/-3.8v mg/day), and folic acid (326.6+/-164.0 vs 383.1+/-215.3 microg/day). We did find statistically significant differences in the intake of the vitamins: A (582.2+/-299.6 vs 771.8+/-602.2 microg/day, p<0.05), B12 (23.4+/-20.3 vs 13.1+/-12.1 microg/day, p<0.001) and B2 (1.6+/-0.4 vs 1.8+/-0.5 mg/day, p<0.05). With respect to mineral intake, we found no statistically significant differences by gender in the intake of the following minerals: calcium (1046.8+/-276.9 vs 1088.9+/-307.7 mg/day), iron (20.2+/-6.6 vs 18.5+/-8.6 mg/day), iodine (73.6+/-37.9 vs 73.8+/-41.1 mg/day), potassium (2804.6+/-1088 vs 2837.5+/-1035.8 mg/day), magnesium (405.4+/-155.3 vs 366.5+/-141.3 mg/day), phosphorus (1407.4+/-408.6 vs 1317.2+/-447.2 mg/day) and zinc (8.9+/-3.3 vs 8.0+/-2.7 mg/day). We found a statistically significant difference (p<0.05) for sodium (2124.9+/-1049.5 mg/day in men and 1728.4+/-992.5 mg/day in women). Our results showed an intake less than the RDA of vit.A, while the vit.B12 intake was greater than the RDA. The intake of the other parameters fitted the recommended values.

Random amplified polymorphic DNA analysis for differentiation of Leuconostoc mesenteroides subspecies isolated from Tenerife cheese

AIMS

In the present study, a RAPD-PCR fingerprinting method was developed to assign Tenerife cheese Leuconostoc mesenteroides strains to its three subspecies (mesenteroides, cremoris and dextranicum).

METHODS AND RESULTS

Arbitrarily primed-PCR gave different DNA banding patterns for each type strain of Leuc. mesenteroides subspecies consisting in three major and intense bands of: 1800, 1600 and 1150 bp for subspecies mesenteroides 1800, 1150 and approximately 350 bp for subspecies cremoris; and 1800, 1600 and 1500 bp for subspecies dextranicum. DNA fingerprints of Tenerife cheese Leuc. mesenteroides subspecies were coincident to that of their respective type strain. RAPD profiles were reproducible with DNA template obtained by two different extraction methods.

CONCLUSIONS

Tenerife cheese Leuc. mesenteroides strains were rapidly and unequivocally assigned to one of the subspecies by comparing their RAPD-PCR fingerprints with those displayed by type strains used as standards. This technique can be applied to complement preliminary identification of Leuc. mesenteroides to the species level by other molecular methods such as protein fingerprinting.

SIGNIFICANCE AND IMPACT OF THE STUDY

RAPD-PCR allows reliable, reproducible and rapid molecular differentiation of Tenerife cheese Leuc. mesenteroides subspecies with no need to use time-consuming and often ambiguous biochemical tests.