Stochastic eco-epidemiological model of dengue disease transmission by Aedes aegypti mosquito

We present a stochastic dynamical model for the transmission of dengue that takes into account seasonal and spatial dynamics of the vector Aedes aegypti. It describes disease dynamics triggered by the arrival of infected people in a city. We show that the probability of an epidemic outbreak depends on seasonal variation in temperature and on the availability of breeding sites. We also show that the arrival date of an infected human in a susceptible population dramatically affects the distribution of the final size of epidemics and that early outbreaks have a low probability. However, early outbreaks are likely to produce large epidemics because they have a longer time to evolve before the winter extinction of vectors. Our model could be used to estimate the risk and final size of epidemic outbreaks in regions with seasonal climatic variations.

Mercury pollution in Ria de Aveiro (Portugal): a review of the system assessment

The Ria de Aveiro (Portugal) is a coast al lagoon adjacent to the Atlantic Ocean and it has an inner bay (Laranjo bay) that received a highly contaminated effluent discharged by a mercury cell chlor-alkali plant from the 1950s until 1994. The aim of this study is to review in a holistic way several research studies that have been carried out in the Ria de Aveiro, in order to evaluate the remobilization of the mercury accumulated within the system and the recovery of the lagoon. The spatial distribution of the total mercury in the surrounding terrestrial environment has also been considered. Results indicate that the main mercury contamination problems in the Ria de Aveiro are confined to the Laranjo bay. Mercury export to the coastal waters and its impact on the nearshore compartments (water column, sediment and biota) are low. No direct effects of the mercury from nearby industrial activities were detected in Aveiro's urban soils, although historical mercury contamination is still affecting soil quality in the immediate vicinity of the chlor-alkali plant, located in Estarreja. Moreover, macrophyte harvesting for human direct or indirect use and the consumption of mussels, crabs and the sea bass from the Laranjo bay may constitute a health risk. Further studies focusing on developing skills for the restoration of the ecosystem are presently underway.

Anaerobic co-digestion of poultry blood with OFMSW: FTIR and TG-DTG study of process stabilization

The potential of anaerobic digestion for the treatment of poultry blood has been evaluated in a co-digestion process. The organic fraction of municipal solid waste (OFMSW) was employed as the co-substrate to avoid digestion inhibition by dilution of nitrogen content and improvement of biodegradability. A semi-continuous mesophilic anaerobic digester was studied with a hydraulic retention time (HRT) of 36 days and an organic loading (OLR1) of 1.5 kg VSS feed m(-3) d(-1). The normal operational conditions of the reactor were altered with the application of an OLR2 of 2.0 kg VSS feed m(-3) d(-1) for a short period causing an imbalance in the process. The reduction of the OLR to initial conditions allowed the recovery of the system. The digestion process reached a final specific gas production (SGP) and a methane yield of 0.33 and 0.20 m3 kg(-1) VSS feed, respectively, maintaining low total and free ammonia concentrations. Fourier transform infrared spectroscopy (FTIR) and thermogravimetric analysis (TGA) were used to gain an insight into transformations experimented by the organic matter at the end of the stabilization process. Furthermore, these analytical techniques were used for evaluating the transformations undergone by the nitrogen-rich protein components of blood after digestion. It was proved that a reduction in volatile content and aliphatic structures of biowastes along with an increase in the degree of aromaticity occurred during the digestion process.

Defining the roles of inflammatory and anabolic cytokines in cartilage metabolism

In osteoarthritis (OA), adult articular chondrocytes undergo phenotypic modulation in response to alterations in the environment owing to mechanical injury and inflammation. These processes not only stimulate the production of enzymes that degrade the cartilage matrix but also inhibit repair. With the use of in vitro and in vivo models, new genes, not known previously to act in cartilage, have been identified and their roles in chondrocyte differentiation during development and in dysregulated chondrocyte function in OA have been examined. These new genes include growth arrest and DNA damage (GADD)45beta and the epithelial-specific ETS (ESE)-1 transcription factor, induced by bone morphogenetic protein (BMP)-2 and inflammatory cytokines, respectively. Both genes are induced by NF-kappaB, suppress COL2A1 and upregulate matrix meatalloproteinase-13 (MMP-13) expression. These genes have also been examined in mouse models of OA, in which discoidin domain receptor 2 is associated with MMP-13-mediated remodelling, in order to understand their roles in physiological cartilage homoeostasis and joint disease.

[Splenic infarction secondary to acute pancreatitis]

BACKGROUND AND OBJECTIVE

the close anatomic relationship of the pancreas with the splenic vessels and the spleen is responsible for splenic complications in the course of acute pancreatitis. Our objective was to report two cases of severe acute pancreatitis complicated by splenic infarction.

PATIENTS

in a three-month period of time two patients were diagnosed with splenic infarction secondary to acute pancreatitis. In both cases splenic infarction diagnosis and follow-up were carried out using computed tomography.

RESULTS

in the first case images clearly showed a narrowing of the splenic artery due to the inflammatory pancreatic condition. In the second case no involvement of the splenic vessels could be demonstrated, hence the only possible etiological explanation was a hypercoagulability state generated by pancreatitis.

CONCLUSIONS

it would be advisable that splenic complications were added to the list of relevant extrapancreatic manifestations. CT is very useful for the diagnosis and follow-up of splenic complications arising in acute pancreatitis.

A new player in cartilage homeostasis: adiponectin induces nitric oxide synthase type II and pro-inflammatory cytokines in chondrocytes

OBJECTIVE

Recent studies revealed a close connection between adipose tissue, adipokines and articular degenerative inflammatory diseases such as rheumatoid arthritis (RA) and osteoarthritis (OA). The goal of this work was to investigate the activity of adiponectin in human and murine chondrocytes and to study its functional role in the modulation of nitric oxide synthase type II (NOS2). For completeness, interleukin (IL)-6, IL-1beta, matrix metalloproteinase (MMP)-2, MMP-3, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-1, prostaglandin E2 (PGE2), leukotriene B4 (LTB4), tumor necrosis factor alpha (TNF)-alpha and monocyte chemoattractant protein-1 (MCP-1) accumulation have been evaluated in adiponectin-stimulated chondrocytes cell culture supernatants.

METHODS

Murine ATDC5 cell line, C28/I2, C20A4, TC28a2 human immortalized chondrocytes, and human cultured chondrocytes were used. Nitrite accumulation was determined by Griess reaction. Adiponectin receptors (AdipoRs) expression was evaluated by immunofluorescence microscopy and confirmed by reverse transcriptase-polymerase chain reaction. NOS2 expression was evaluated by Western blot analysis whereas cytokines, prostanoids and metalloproteinases production was evaluated by specific enzyme-linked immunosorbent assays.

RESULTS

Human and murine chondrocytes express functional AdipoRs. Adiponectin induces NOS2. This effect is inhibited by aminoguanidine, dexamethasone and by a selective inhibitor of phosphatidylinositol 3-kinase. In addition, adiponectin is able to increase IL-6, MMP-3, MMP-9 and MCP-1 by murine cultured chondrocytes whereas it was unable to modulate TNF-alpha, IL-1beta, MMP-2, TIMP-1, PGE2 and LTB4 release.

CONCLUSIONS

These results bind more closely the interactions between fat-derived adipokines and articular inflammatory diseases, and suggest that adiponectin is a novel key element in the maintenance of cartilage homeostasis which might be considered as a potential therapeutical target in joint degenerative diseases.

Co-combustion of different sewage sludge and coal: a non-isothermal thermogravimetric kinetic analysis

The kinetics of the combustion of coal, two different sewage sludge and their blends (containing different dried weight percentages of sewage sludge) was studied by simultaneous thermogravimetric analysis. Once the weight percentage of sludge in the blend was 10%, the effects on the combustion of coal were hardly noticeable in terms of weight loss. The Arrhenius activation energy corresponding to the co-combustion of the blends was evaluated by non-isothermal kinetic analysis. This showed that, though differences between coal and sewage sludge, the combustion of their blends kept kinetically alike to that of the coal. This work illustrates how thermogravimetric analysis may be used as an easy rapid tool to asses, not only mass loss, but also kinetics of the co-combustion of sewage sludge and coal blends.

Adsorption of heavy metals onto sewage sludge-derived materials

Two materials were produced from sewage sludge by: (1) pyrolysis of dried sewage sludge (PS); (2) chemical activation of dried sewage sludge with ZnCl(2) followed by pyrolysis (AS). The aim was to study the application of these materials for metal purification from water and to determine the efficiency of each material. Although AS displayed higher capacity, both PS and AS were able to adsorb these metals and the preferential order was equal: Hg(II)>Pb(II)>Cu(II)>Cr(III). For each metal-adsorbent pair, metal adsorption was highly pH dependent. In all cases the equilibrium was well described both by the Langmuir and the Freundlich isotherms. At the corresponding optimum pH, AS showed the following adsorption capacities: 175.4, 64.1, 30.7 and 15.4 mg/g of Hg(II), Pb(II), Cu(II) and Cr(III), respectively. These results indicate the potential application of these sewage sludge based adsorbents for the treatment of metal polluted effluents.

HPV and cervical cancer testing and prevention: knowledge, beliefs, and attitudes among Hispanic women

Cervical cancer is a preventable disease resulting from infection with high-risk types of sexually transmitted human papillomaviruses (HPVs). Public knowledge of HPVs and their link to cervical cancer is limited. Participation in cervical cancer prevention programs, including Pap and HPV screening and HPV vaccine acceptance, is crucial for limiting the incidence of cervical cancer. Hispanic women suffer the highest cervical cancer incidence rates in the United States. In this study, we conducted community-based focus groups with Hispanic women to explore knowledge and attitudes relating to cervical cancer, HPV, HPV testing, and HPV vaccination. Study findings suggest a need to increase public health literacy in relation to HPV, the link between HPV and cervical cancer, and HPV primary and secondary prevention options. Health care providers should be prepared to share information with patients that supports and promotes informed decision making about HPV testing and vaccines and their complementary roles in cervical cancer screening and prevention.

Effects of sewage sludge blending on the coal combustion: a thermogravimetric assessment

Combustion of urban sewage sludge together with coal in existing infrastructures may be a sustainable management option energetically interesting for these materials, usually considered wastes. Thermogravimetric analysis was used to study the combustion of a semianthracite coal and the modifications undergone when adding a small percentage (2%, 5%, 10%) of sewage sludge. Both Differential Scanning Calorimetric analysis and Differential Thermogravimetry burning profiles showed differences between coal and sewage sludge combustion. However, the effects of adding a percentage of sewage sludge equal or smaller than 10% was hardly noticeable in terms of heat release and weight loss during the coal combustion. This was further proved by non-isothermal kinetic analysis, which was used to evaluate the Arrhenius activation energy corresponding to the co-combustion of the blends. This work shows that thermogravimetric analysis may be used as an easy rapid tool to asses the co-combustion of sewage sludge together with coal.

[Recommendations guide for the treatment of migraine in the clinical practice]

Migraine is the most frequent neurological reason for consultation. The differences regarding health care system, type of professional seeing these patients and therapeutic armamentarium available in the different countries are important, which makes it very recommendable to have an action guide that reflects the local clinical practice. Following the year 2005 WHO recommendations in its "Global Campaign" against migraine, the coordinators of the Headache Study Groups of the Spanish Society of Neurology, the Spanish Society of Family and Community Medicine, the Spanish Society of Rural and General Medicine, the Spanish Society of General Medicine and the Global Campaign decided to jointly make this guide. To do so, they made a search in MEDLINE, using the terms "migraine", "migraine treatment" and "headache guidelines" and "migraine guidelines". The most relevant articles were analyzed, including the references that we considered to be of interest. Furthermore, we reviewed the most important textbooks on headache and migraine. In this paper, we detail the recommendations agreed on, according to the evidence grade, on symptomatic and preventive treatment of migraine.

Side effects of sunitinib malate (SM) treatment for patients (pts) with metastatic renal cell carcinoma (mRCC)

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Background: SM is a tyrosine kinase inhibitor recently approved for treatment of mRCC. Side effects of treatment have been investigated in 51 pts with mRCC and 35 out 51 enrolled pts resulted evaluable for response. Methods: Pts were clinically evaluated before therapy and each month during SM treatment; haematological and biochemical parameters were measured after each cycle. Thyroid function was also evaluated measuring thyroid-stimulating-hormone (TSH), serum free thyroxine (FT4) and triiodothyronine (FT3), before the start and after 6 months of treatment. Results: Toxicity was evaluated according to NCI-CTC. Neutropenia grade 3 was observed in 7 pts (13,7%), grade 2 in 13 (25%); anemia grade 3 was found in 3 pts (5,8%) and grade 2 in 6 (11,7%); thrombocytopenia grade 3 was found in 6 pts (11,7%), grade 2 in 5 (9,8%). Mucositis resulted a frequent side effect. In fact, 4 (7,8%) pts showed a grade 3 toxicity, 16 (31,3%) grade 2 and 10 (19,8%) grade 1 Among 29 out 35 (82,8%) pts who responded to therapy, 3 had mucositis grade 3, 15 grade 2, 9 grade 1. Conversely, among 6 out 35 (17,1%) pts who had progressive disease during treatment, mucositis was observed in only 2 pts. 24 pts out 35 who received 6 months SM treatment were reevalueted for thyroid function. No patient had thyroid dysfunction before treatment. Conversely, 8 pts showed severe ipothyroidism (TSH, FT3 and FT4 out of the normal range) and 6 others intermediate ipothyroidism (only TSH increased over 20 μU/ml) after at least 6 cycles of therapy. Conclusions: SM therapy represents a new interesting approach to the treatment of mRCC, but shows noteworthy side effects. Regular monitoring of thyroid function with administration of levothyroxin substitutive treatment at the appearance of the thyroid disfunction is required. A direct correlation between grade 2–3 mucositis and clinical response to treatment could be postulated on the basis of our data, although a statistical analysis on a greater cohort of subjects is required to confirm this observation.

No significant financial relationships to disclose.

Sunitinib: bridging present and future cancer treatment

Tyrosine kinase receptors (RTKs) are a heterogeneous group of transmembrane proteins involved in signal transduction. These receptors are expressed in many different cells and regulate cellular growth, differentiation and angiogenesis. Overexpression and/or the structural alteration of different RTKs classes are generally associated to cancer and, when RTKs-mediated signal transduction pathways are abnormally activated, generate cancer growth, angiogenesis and metastatization. Therapeutic intervention targeting RTKs concerns antagonist drugs as little molecules or monoclonal antibodies. Sunitinib malate is a little molecule able to block intracellular tyrosine kinase domain of RTKs, which has both direct anticancer and antiangiogenetic activity. Sunitinib targets selectively vascular endothelial growth factor, KIT, Flt3 and platelet-derived growth factor receptors and the receptor encoded by the ret proto-oncogene. This drug is used in the treatment of gastrointestinal stromal cancer (GIST) resistant to imatinib and metastatic renal cell carcinoma (RCC). In this review, we report preclinical data of sunitinib, even about synergism with chemotherapy and radiotherapy, data relative to phase III trials of sunitinib in the treatment of GIST and RCC, and we try to plan what will be future applications of sunitinib in different types of cancer, even in association to chemotherapy, radiotherapy and monoclonal antibodies.

[Evaluation of the social care program for persons with severe mental disorders: a Delphi study]

BACKGROUND

In January 2005 the Government of Navarre approved the "Care Program for Persons with Severe Mental Disorder" (PA-TMG). This article is intended to ascertain the opinion of experts regarding the PA-TMG. To identify the elements of agreement in the evaluation of positive aspects and aspects that can be improved. To make recommendations on the basis of their opinions.

METHODS

A Delphi study was designed with 34 experts in health or social care of mentally ill persons. By means of repeated questionnaires, ideas that achieved a consensus of (3)90% were identified and a level of priority was assigned. The percentages of agreement and descriptive statistics of priority were presented, and the recommendations of analysis of the areas of consensus were drawn up.

RESULTS

Out of the 34 participating experts, 25 (71.4%) completed the study: 1 sociologist, 5 social workers, 3 psychiatrists, 5 psychologists, one representative of the families, 3 occupational therapists, 1 technician in social integration and 6 family doctors. Sixty-four percent evaluated the Plan positively, and 72% were of the opinion that it was drawn up without sufficient professional participation. All thought that it could be improved by widening the participation of experts.

CONCLUSIONS

The principal ideas on which there was consensus were: socio-health care must be guaranteed by the public administration; good systems of information and evaluation must be established; the Plan must have its own budget; professional follow-up of the patient by the different mechanisms must be guaranteed; a lot of the decision making must be decentralised; access to social benefits for these patients must be universalised.

Fluorescence and DOC contents of estuarine pore waters from colonized and non-colonized sediments: effects of sampling preservation

The influence of the colonization of salt marsh sediments with Halimione portulacoides was evaluated by analysing the fluorescent dissolved organic matter (FDOM) in sediment pore waters from a salt marsh at different depths. Cores of sediments at colonized and non-colonized sites were collected from a coastal lagoon (Ria de Aveiro, Portugal). The DOC content of extracted pore waters was determined and characterized by synchronous molecular fluorescence (Deltalambda=60nm) and UV-visible spectroscopies. The common practice of freezing sediment cores for further and later chemical investigation was shown not to be an appropriate methodology of sample preservation. On the contrary, freezing of extracted and filtered pore water seemed not to affect either the DOC content or the fluorescence properties of pore waters. Two types of fluorescent substances were found in the pore waters spectra; one corresponding to humic-like substances and another one resembling proteins. However, major differences were found in the spectra of pore waters depending on both depth and the presence/absence of vegetation colonization.

Towards a pro-inflammatory and immunomodulatory emerging role of leptin

Leptin is a 16 kDa adipocyte-secreted hormone that regulates weight centrally and links nutritional status with neuroendocrine and immune function. Since its cloning in 1994, leptin's role in regulating immune and inflammatory response has become increasingly evident. Actually, the increase of leptin production that occurs during infection and inflammation strongly suggests that leptin is a part of the cytokines loop which governs the inflammatory-immune response and the host defence mechanism. Indeed, leptin stimulates the production of pro-inflammatory cytokines from cultured monocytes and enhances the production of Th1 type cytokines from stimulated lymphocytes. Several studies have implicated leptin in the pathogenesis of autoimmune inflammatory conditions such as type 1 diabetes, rheumatoid arthritis and chronic bowel disease. Obesity is characterized by elevated circulating leptin levels which might contribute significantly to the so called low-grade systemic inflammation, making obese individuals more susceptible to the increased risk of developing cardiovascular diseases, type II diabetes or inflammatory articular degenerative disease such as osteorathritis (OA). As a matter of fact, a key role for leptin in OA has been recently demonstrated since leptin exhibits, in synergy with other pro-inflammatory cytokines, a detrimental effect on articular cartilage cells by promoting nitric oxide synthesis. This review will focus prevalently on the complex relationships existing among leptin, inflammatory response and immunity, trying to provide surprising insights into leptin's role and to discuss challenges and prospects for the future.

Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence

OBJECTIVE

We studied the long-term outcome after an anal sphincter tear.

STUDY DESIGN

From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7%) who sustained a sphincter tear and 445 controls. Eighteen years after the delivery, we mailed them a questionnaire and graded fecal incontinence with the Wexner score, a summary of incontinence to flatus, liquid, or solid stools; need to wear a pad; and lifestyle alterations. We predefined severe incontinence as a score above 4 of 20.

RESULTS

Five hundred forty of 890 women (61%) returned the questionnaire. Severe fecal incontinence was reported by 34 of 259 women (13.1%) after a sphincter tear and 22 of 281 controls (7.8%) (risk ratio 1.7, 95% confidence interval 1.0 to 2.8). Only 6.4% of the reports of fecal incontinence were attributable to a sphincter tear.

CONCLUSION

Fecal incontinence is frequently reported, even by women who have not sustained an anal sphincter tear. Only a small fraction of fecal incontinence can be attributed to sphincter tears.

Women's health 18 years after rupture of the anal sphincter during childbirth: II. Urinary incontinence, sexual function, and physical and mental health

OBJECTIVE

We studied maternal health 18 years postpartum in women having sustained an anal sphincter tear and controls.

STUDY DESIGN

We assessed symptoms with the short form of the urogenital distress inventory, the female sexual function index, and physical and mental health with the Short Form-12 summary scales.

RESULTS

Women with a sphincter tear had no increased risk of urinary symptoms (54 of 251, 22%, versus 51 of 273, 19%, risk ratio 1.2, 95% confidence interval 0.8 to 1.6) or sexual symptoms (84 of 223, 38%, versus 90 of 230, 39%, risk ratio 1.0, 95% confidence interval 0.8 to 1.2). Their physical health was also similar to controls (mean score +/- SD, 47 +/- 7 versus 47 +/- 6), whereas their mental health was slightly lower (score 45 +/- 6 versus 46 +/- 6, difference 1, 95% confidence interval 0 to 2, P = .05).

CONCLUSION

Women who sustained an anal sphincter tear have no more urinary or sexual symptoms 18 years after delivery.

Peter's delusions inventory in Spanish general population: internal reliability, factor structure and association with demographic variables (dimensionality of delusional ideation)

INTRODUCTION

Several lines of evidence suggest the existence of a continuum on psychotic symptoms, including delusions. Moreover, several studies have reported differences regarding prevalence and intensity of these symptoms in relation to age, gender and educational level. This study tries to analyze distribution and dimensionality of delusional ideation in the general population, as well as relationship between gender, age and educational level with the prevalence of these symptoms.

METHOD

We used the 21-item Peters. Delusions Inventory (PDI-21) on a general population sample as our measure of delusional ideation. A factor analysis was carried out to determine the dimensionality of delusional ideation. Next, linear regression analyses were performed to analyze the relationship of age, gender and educational level with the different dimensions.

RESULTS

365 subjects completed the inventory. Factor analysis revealed the presence of 7 easily interpretable factors. Five of these factors were negatively correlated with age. Women had higher scores on the "magical thinking" factor. Finally, lower educational level was correlated with higher scores on those factors of "magical thinking" and "experiences of influence".

CONCLUSIONS

It appears that the PDI-21 is a useful instrument to measure dimensionality of delusional ideation in Spanish general population. Results of the influence of gender, age and educational level are in agreement with those reported in psychosis samples, supporting the existence of a continuum in psychoses.

Changes in plasma levels of fat-derived hormones adiponectin, leptin, resistin and visfatin in patients with rheumatoid arthritis

BACKGROUND

Rheumatoid arthritis is a chronic autoimmune inflammatory condition characterised by polyarthritis and severe change in body mass and neuroendocrine environment.

OBJECTIVES

To investigate plasma levels of adipocytokines (leptin, adiponectin, visfatin and resistin) in patients with rheumatoid arthritis and to compare them with levels in healthy controls.

METHODS

Adiponectin, resistin, visfatin and leptin concentrations were measured in 31 patients with rheumatoid arthritis and 18 healthy controls by using specific enzyme-linked immunosorbent assays.

RESULTS

Patients with rheumatoid arthritis showed considerably higher plasma levels of leptin, adiponectin and visfatin than healthy controls. No marked difference was observed in resistin levels between patients and controls.

CONCLUSION

A marked increase in plasma levels of leptin, adiponectin and visfatin was noted in patients with rheumatoid arthritis, whereas resistin levels were similar to those observed in healthy controls. Coordinated roles for adiponectin, leptin and visfatin are suggested in the modulation of the inflammatory environment in patients with rheumatoid arthritis, whereas the lack of modulation in resistin levels is predictive of an irrelevant role for this peptide, suggesting that resistin level is probably not one of the main signals associated with the pathogenesis of this disease.