Early estimates of the effectiveness of the 2011/12 influenza vaccine in the population targeted for vaccination in Spain, 25 December 2011 to 19 February 2012

We present early estimates of influenza vaccine effectiveness (VE) in the population targeted for vaccination, during 25 December 2011 to 19 February 2012. The adjusted VE was 55% (95% CI: 3 to 79) against any type of influenza virus and 54% (95% CI: 1 to 79) against influenza A(H3N2) virus. This suggests a moderate protective effect of the vaccine in the targeted population in a late influenza epidemic with limited match between vaccine and circulating strains.

The Solubility of Unirradiated UO2 In Both Perchlorate And Chloride Test Solutions. Influence of the Ionic Medium

The solubility of a crystalline unirradiated UO2 (s) has been studied under reducing conditions at 25°C in three different ionic media: 0.008 mol dm–3 NaCIO4, 1 and 5 mol dm-3 NaCl+. The species responsible for the solubility in perchlorate medium are U(OH)3 and U(OH)4, with the stability constants log β13 = -0.4(±0.2) and log β14 = -5.7(±0.1), respectively. The solubility in both1! and 5 M chloride media is explained at pH values higher than 6 by the species U(OH)4 with log β14 = -5.5(±0.2) while at lower pH values an abnormal behaviour is observed, with higher uranium concentrations in solution and a proton independent solubility for pH values lower than 4. The XPS observations of the reacted solids do not show the presence of solid surface phases other than uranium dioxide, with an upper oxidation state of UO2.1.

Mineralization enhancement of a recalcitrant pharmaceutical pollutant in water by advanced oxidation hybrid processes

Degradation of the biorecalcitrant pharmaceutical micropollutant ibuprofen (IBP) was carried out by means of several advanced oxidation hybrid configurations. TiO(2) photocatalysis, photo-Fenton and sonolysis - all of them under solar simulated illumination - were tested in the hybrid systems: sonophoto-Fenton (FS), sonophotocatalysis (TS) and TiO(2)/Fe(2+)/sonolysis (TFS). In the case of the sonophoto-Fenton process, the IBP degradation (95%) and mineralization (60%) were attained with photo-Fenton (FH). The presence of ultrasonic irradiation slightly improves the iron catalytic activity. On the other hand, total removal of IBP and elimination of more than 50% of dissolved organic carbon (DOC) were observed by photocatalysis with TiO(2) in the presence of ultrasound irradiation (TS). In contrast only 26% of mineralization was observed by photocatalysis with H(2)O(2) (TH) in the absence of ultrasound irradiation. Additional results showed that, in the TFS system, 92% of DOC removal and complete degradation of IBP were obtained within 240 min of treatment. The advanced oxidation hybrid systems seems to be a promising alternative for full elimination/mineralization for the recalcitrant micro-contaminant IBP.

Ultrasonic treatment of water contaminated with ibuprofen

The application of ultrasound (US) waves for remediation of wastewater is an area of increasing interest and promising results. The aim of this paper is to evaluate the influence of several parameters of the US process on the degradation of ibuprofen (IBP), a widely used non-steroidal anti-inflammatory recalcitrant drug found in water. Applied US power, dissolved gas, pH and initial concentration of IBP were the parameters investigated under sonication (300 kHz). Ultrasound increased the degradation of IBP from 30 to 98% in 30 min. Initial rate of IBP degradation was evaluated in the range of 1.35 and 6.1 micromolL(-1)min(-1) for initial concentrations of 2 to 21 mgL(-1) or 9.7 micromolL(-1) to 101 micromolL(-1), respectively. Under air and oxygen the degradation rate of IBP was 4 micromolL(-1)min(-1) being higher than that when argon was used. The most favorable degradation pH was acidic media. Complete removal of IBP was achieved but some dissolved organic carbon (DOC) remained in solution showing that long-lived intermediates were recalcitrant to the US irradiation. However, chemical and biological oxygen demands (COD and BOD(5)) indicated that the process oxidize the ibuprofen compound to biodegradable substances removable in a subsequent biological step.

Intestinal stenting in preterm, very-low-birth-weight infants with necrotizing enterocolitis and multiple perforations

We present 2 cases of necrotizing enterocolitis with multiple intestinal perforations or areas of segmental bowel necrosis in preterm, very-low-birth-weight infants. We reviewed their charts and researched the related literature. We used SILASTIC (Silmag, Argentina) intestinal stents to avoid multiple formal bowel anastomosis or stomas and longer resections, and to reduce operative time. In the first case, we externalized the stent through the first and last perforation; and in the second, through a proximal jejunostomy and the orifice left after an appendectomy. This method was useful in avoiding short bowel syndrome in both infants, and they were discharged successfully. They are currently 31/2 and 2 years old, respectively, eating without any restriction and with mild developmental delays. Treatment of preterm infants with multiple bowel perforations or areas of bowel necrosis requires a maximal effort to preserve as much intestinal length as possible. Use of the SILASTIC stent technique provides a good treatment variant in selected cases to preserve bowel length, reduce operative time, and avoid short bowel syndrome.

Cystic fibrosis in a southern Brazilian population: characteristics of 90% of the alleles

Cystic fibrosis (CF) is a genetic disease that frequently leads to death in infancy among Europeans and their descendants. The goals of the present study were to analyze the molecular aspects of CFTR gene characterizing mutations, their frequencies, and the haplotypes formed by four CFTR gene intragenic markers, IVS8-6(T)n, IVS8CA, IVS17bTA and IVS17bCA, in a southern Brazilian population of Caucasian origin. DNA samples from 56 non-related CF patients were analyzed using scanning techniques (single strand conformation polymorphism and denaturing gradient gel electrophoresis), restriction fragment length polymorphism and direct DNA sequencing to identify the mutations. Our results revealed a total of 25 different CF mutations representing nearly 90% of CF alleles, two being novel mutations. Microsatellite haplotypes were defined for CF and normal alleles. The mutational spectrum and the associated haplotypes described for the first time in this study should prove relevant for genetic counselling and CF population screening in Brazil. Moreover, our results suggest the presence of a major Mediterranean component in the contemporary Brazilian CF patient pool.

[A new method of ostial revascularization of digestive and renal arteries in complex obstructive aortic pathology]

A new method of revascularization of digestive and renal arteries is reported in this paper, accomplished through the intra-aortic or ostial root, in a 53-year old woman, with the diagnosis of thrombotic occlusion of the terminal aorta associated to a protuberant and calcified lesion of the supraceliac aorta ("coral reef"). The procedure consisted in the implantation of a bifurcated prosthesis from the descending thoracic aorta to both common iliac arteries, through the diaphragm, followed by a longitudinal aortotomy aimed at the removal of the "coral reef" lesion and revascularization of renal, mesenteric and celiac arteries, by means of additional prosthesis placed between the bypass graft and the ostia of these arteries. The left renal artery was reattached to the bypass graft. Visceral ischemic times were short. The post operative course was uneventfull. Two months later, an angio-CT disclosed the complex procedure of revascularization working in excellent condition. The advantages of this new method of revascularization of abdominal visceral arteries in complex obstructive aortic pathology are analysed and discussed.

Effects of phospholipid vesicles (liposomes) on cAMP levels in the rat cerebral cortex

We studied the effects of two types of liposomes (cholate-free liposomes and cholate-containing liposomes) on control (in the presence of 3-isobutyl-1 methyl xanthine [IBMX], a phosphodiesterase inhibitor) and stimulated (IBMX plus isoprenaline) cyclic 3',5'-adenosine monophosphate (cAMP) accumulation in slices of rat cerebral cortex. Our purpose was to examine whether or not liposomes with different lipid constituents modify levels of cAMP in vitro. Liposomes at low concentrations had a significant inhibitory effect on cAMP accumulation in brain tissue. This inhibition was concentration-dependent. Cholate-containing liposomes had a greater inhibitory effect at higher concentrations. Liposomes also inhibited cAMP accumulation in a dose-dependent manner when the tissues were preincubated with ouabain, a Na(+)-K(+)-ATPase inhibitor. These results demonstrate that, in rat brain, liposomes alone modified important biochemical responses such as the adenylyl cyclase-cAMP system coupled to beta-adrenoceptors. The significance of these findings for the mechanism of the action of liposomes is discussed.

Testicular CFTR splice variants in patients with congenital absence of the vas deferens

The involvement of the five thymidine (5T) variant in intron 8 of the cystic fibrosis membrane regulator (CFTR) gene in congenital bilateral absence of the vas deferens (CBAVD) phenotype has been extensively demonstrated. This variant leads to alternative splicing of the CFTR gene which results in a wild-type transcript and one without exon 9. Little is known about expression of the CFTR gene in the testis. We analysed the level of the aberrantly spliced transcripts in testicular biopsies and correlated it with disease expression. Quantitative RT-PCR analysis in testicular biopsies from control and CBAVD patients showed a correlation between the length of the IVS8-6(T) n tract and the level of alternatively spliced transcripts. Results from histological analysis also suggest an involvement of the alternative transcript in the spermatogenic status of patients, leading to a decreased number of mature sperm forms in the tubule.

Characterization of recombinant hepatitis B surface antigen using surface plasmon resonance

Two commercial monoclonal antibodies were shown to interact with distinct epitopes within the major antigenic a determinant region of yeast recombinant hepatitis B surface antigen (rHBsAg) particles, contained in the hepatitis B vaccine, by using the surface plasmon resonance phenomenon on a BIAcore system. Apparent avidity for these antibodies were compared among different rHBsAg batches, showing the consistency of these epitopes. Furthermore, the effect of the alteration of these epitopes, achieved by chemical modifications, was readily reflected by changes in the apparent avidity for these antibodies. The procedures used in the present study provide a novel and efficient way to characterize rHBsAg particles present in different hepatitis B vaccine products.

Prenatal diagnosis of cystic fibrosis in a highly heterogeneous population

Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasian populations. The Spanish CF population is highly heterogeneous, with more than 70 different mutations causing CF. Since the CFTR gene was cloned, we have performed 81 prenatal diagnoses for 74 couples. Sixty-nine cases had a high risk (1/4) for CF and 12 presented a lower risk (1/240). Direct analysis was possible in 36 cases (44.4 per cent); it was necessary to combine mutation analysis with polymorphic markers in 24 cases (29.6 per cent); mutation analysis and microvillar enzymatic (MVE) analysis were combined in five cases (6.1 per cent); and in 16 cases (19.8 per cent), only indirect analysis was possible. Nine different mutations were detected in this series of families: 621 + 1G -> T, delta F508, 1609delCA, G542X, G551D, 1949del84, R1162X, W1282X, and N1303K. Another ten mutations were identified in these samples after prenatal diagnosis (1811 + 1.6kbA -> G, 711 + 1G -> T, 2869insG, G85E, 2176insC, delta I507, 3272-26A -> G, Q890X, R1066C, and 4005 + 1G -> A). Our current strategy for molecular diagnosis of CF in the Spanish population is based, as a first step, on direct analysis for the two most frequent mutations (delta F508 and G542X) and indirect analysis using the intragenic markers IVS8CA, IVS17BTA, and IVS17BCA. The second step consists of screening for the mutations already associated with the CFTR microsatellite haplotypes. The third step is a specific search for unknown mutations. While actual diagnostic methods are not automatic and robust enough for heterogeneous populations, the diagnostic strategy outlined provides rapid, accurate, and reliable prenatal diagnosis for the majority of couples.

Description of a new quotient that may differentiate blood pressure profiles in essential versus Cushing's syndrome-related hypertension

Since the presence or absence of a nocturnal decrease in blood pressure values (BP) may suggest an increased risk of visceral complications or the existence of secondary hypertension, several methods have been described for evaluating the BP profile. Nevertheless, a universally accepted system to evaluate this item has not yet been established. Our aim in this study was to test different dispersion quotients (DQ) which estimate the differences between the mean of each hour, and the mean of all the readings in the 24 h period. These quotients may be employed regarding systolic (SBP) or diastolic (DBP) blood pressure, and may be referred to the whole period of 24 h, or to the subperiods morning (m), afternoon (a) or night (n). We have studied two non selected groups of essential (n = 20) or secondary (Cushing's syndrome, n = 17) hypertensives. We observed a marked decrease in these quotients, particularly DQ-SBP and nDQ-SBP, in secondary hypertensives (respectively 10.2 +/- 2.9 vs 15.6 +/- 4.2 and 11.8 +/- 5.0 vs 20.5 +/- 6.3, p < 0.0001), thus indicating, a blunted nocturnal fall of BP in these patients. Also the DQ and particularly DQ-SBP, nDQ-SBP and nDQ-DBP, showed a high positive and negative predictive value, sensitivity and specificity for pertaining to the Cushing's syndrome group (respectively: 0.75, 0.88, 0.88, 0.75; 0.86, 0.82, 0.77 0.90; and 0.78, 0.84, 0.82, 0.80).

Ambulatory blood pressure monitoring in physicians working in a hospital: is there an increase in the number of subjects with high workplace blood pressures?

Sixty-two physicians from our hospital who were normotensives, as supported by casual blood pressure measurements, underwent 24-h blood pressure monitoring which included their normal work, home rest and sleep periods. During working hours, 19% of the subjects showed mean diastolic and/or diastolic plus systolic blood pressures higher than those admitted as normal by the WHO for casual measurements for out of work subjects. Both mean systolic and diastolic blood pressure measurements, during the work at the hospital, were significantly higher in males (P < 0.01 and P < 0.005, respectively) than the mean of the readings obtained during the 24-h period, but this phenomenon did not occur among the females. Male's mean systolic (129.8 +/- 10.6 vs. 117.1 +/- 9.7 mmHg, P < 0.0001) and diastolic pressures (83.4 +/- 8 vs. 74.9 +/- 7.3 mmHg, P < 0.001) were significantly higher during the working period in relation to those of the female group. Discussing the influence of the kind of work on blood pressure, we came to the conclusion of the existence in our environment of a group of subjects (generally males), presenting high blood pressure values during their working period at the hospital and normal or borderline values during the rest of the day. This should be of interest, since it has been reported that subjects with high workplace blood pressure have an increased risk of hypertension and target-organ damage.

[Introducing patient-controlled analgesia in a private hospital]

Patient controlled analgesia (PCA) is now a well recognized technique for postoperative analgesia. This study reports an experience of 24 months with 768 patients in a French private hospital. The first step was to train the team for this new technique. The second step was to agree on standards of prescription and safety monitoring rules (respiratory rate plus sedation score), as well as on the selection of patients. Analgesia was obtained with self administrated bolus plus a constant infusion (0.5 milligram per hour) of morphine in all patients, and in some with an addition of paracetamol or ketoprofene for a sparing effect on morphine consumption. All patients were returned to their ward, after an initial titration of pain treatment in the recovery room. No major problems occurred during the study period. In 13 patients the respiratory rate decreased to or under 10 c.min-1 without increased sedation and for safety reasons, the PCA was discontinued. PCA is now routinely used postoperatively for a majority of painful procedures in our institution.

Calcium-dependent release of norepinephrine from permeabilized PC12 cells is inhibited by approximately 48 and approximately 112 kDa fragments of botulinum neurotoxin type E

Permeabilized PC12 cells exhibit a Ca(2+)-stimulated norepinephrine secretory pathway which is sensitive to botulinum neurotoxin serotypes A, B and E [Lomneth R., Martin T.F.J. and DasGupta B. R. (1991) J. Neurochem. 57: 1413-1421]. Two novel amino terminal fragments of the 150 kDa neurotoxin serotype E (approximately 112 and 48 kDa), produced by digestion with pepsin, were tested in permeabilized PC12 cells. The intracellular inhibitory activity of the approximately 112 kDa amino terminal fragment, like that of the 150 kDa neurotoxin, was progressively enhanced after trypsinization and dithiothreitol reduction. The approximately 50 kDa C-terminal half of the heavy chain therefore does not contribute to the enhancement of inhibitory activity. The approximately 48 kDa amino terminal light chain-like fragment completely inhibited release of norepinephrine, with an IC50 = 500 pM (more potent than the light chain isolated after digestion with trypsin) not requiring reduction with dithiothreitol. These results clarify the molecular basis of activation of neurotoxin by trypsin and dithiothreitol.