Effect of Nut Paste Enrichment on Wheat Dough Rheology and Bread Volume

The study was carried out to investigate the effect of nuts (almond, hazelnut, peanut, walnut) enrichment (5, 10 and 15%) on the rheological properties of dough using alveograph, consistograph and rheofermentometer measurements. The loaf volume (LV) of bread added nut paste was also determined. The increase in nut percentage increases the dough viscoelastic characteristics (tenacity, extensibility, and strength) and mixing time, but decreased the dough consistency and tolerance, and the CO2 production during fermentation. Loaf volume increased when 5 and 10% of nut paste are added. Dough added walnut paste presented the lowest tenacity, strength and water absorption values, but the highest values in dough development time, tolerance and stability. Dough added almond, hazelnut and peanut paste had a similar behavior during mixing and handling.

Late noncardiac surgery in heart transplant patients

OBJECTIVE

Because of improved long-term survival of heart transplants (HT), patients often need noncardiac surgery (NCS). Immunosuppression may increase the infection rate. Inadequate management may increase the risk of dysfunction or acute rejection episodes (ARE). Long-term outcomes of NCS and optimal immunosuppressive management in the perioperative period are not well known. The objective of this study was to analyze the incidence, morbidity, and mortality of late NCS after HT.

METHODS

We retrospectively evaluated the incidence and type of late NCS as well as the risk factors for complications and the mortality among 207 HT patients. Immunosuppression and ARE rates were also analyzed.

RESULTS

One hundred and sixteen late NCS (84.5% elective) were performed in 72 HT patients (34.8%). Interventions were: 35 urologic (30.2%), 29 abdominal (25%), 14 vascular (12.1%), 13 ENT (11.2%), 11 skin and soft tissue (9.5%), and 7 orthopedic (6%). Malignancy was the main indication for NCS (33.6%). Only 4 patients (5.6%) died preoperatively. Mortality was higher among emergent vs elective procedures (16.6% vs 1%; P = .012) and among patients with preoperative high vs middle/low risk (26.6% vs 0%). Postsurgical infection was the most frequent complication (6.9%). However, there were no relevant complications in 82.8% of HT patients. Hospitalization time was <15 days in two thirds of patients. Immunosuppression was modified in 33 patients (28.4%), especially when the surgical indication was neoplasia (P < .001). None of the patients with NCS displayed allograft dysfunction or an ARE.

CONCLUSIONS

More than one-third of HT patients needed a late NCS. In our experience, elective surgical procedures with middle/low preoperative cardiovascular risk are safe. In this context, the risk of rejection was low when immunosuppression was carefully monitored to reduce the risk of infection.

Effects of portal versus systemic venous drainage in pancreas and kidney-pancreas transplantation

We performed a retrospective analysis to compare pancreas transplantation with systemic-enteric drainage (SE) or portal-enteric drainage (PE).

METHODS

We reviewed 38 consecutive pancreas transplants including 31 simultaneous kidney-pancreas (SKP) and 7 pancreas after kidney (PAK), using either systemic (n = 18) or portal (n = 20) venous drainage. Demographic, clinical, and immunologic variables were similar for both groups.

RESULTS

There were no significant differences in patient, kidney, or pancreas allograft survival rates after a mean follow-up of 23 months (range 1-60). The mean length of hospital stay within 3 months was 34 days among the SE group versus 20 days in the PE group (P = ns). The incidences of intraabdominal infection, early relaparotomy, and acute rejection episodes were not different between groups. The blood pressure levels were similar among the SE and PE groups. There was no significant difference in creatinine, or fasting glucose, C-peptide, cholesterol, or triglyceride levels or homeostatic model assessment (HOMA) beta cell, HOMA-S, and HOMA-IR index. HbA1c was lower at 6 and 12 months in the PE group (P < .05). Mean prednisone and mycophenolate mofetil doses as well as tacrolimus levels were identical for both groups.

CONCLUSION

The results suggested sustained long-term endocrine function in both groups, showing that in the short term, portal venous drainage did not offer major metabolic or immunologic advantages compared with systemic delivery of insulin.

Homogeneous nucleation: Classical formulas as asymptotic limits of the Cahn-Hilliard approach

Classical expressions for the critical cluster work of formation approximate the nonclassical expressions based in the density functional theory of capillarity for the limit of low supersaturation degrees. However, the ratio between classical and nonclassical expressions for nucleation rates grows as the supersaturation degree decreases. Here, with the aim to obtain simple and more accurate expressions that approximate the modern nucleation rate formulas, an asymptotic expansion of the Cahn-Hilliard expression of the critical work of formation is developed within the limit of low supersaturation. In such asymptotic expansion, terms up to third order are retained. The ratios between the corrected classical expressions and the nonclassical ones are now decreasing for supersaturation degrees tending to zero. However, the corrected approximate formulas are as difficult to handle as the exact Cahn-Hilliard expressions. When only the two first low-order terms of the asymptotic expansion are retained, a simpler corrected classical expression is obtained but it can only approximate nonclassical expressions up to order unity. Finally, using a Becker-Doring model of nucleation, the kinetic prefactor of the critical nuclei rate of formation is modeled consistently with the Cahn-Hilliard approach to the critical work of formation.

Clinical heterogeneity of recessive ataxia in the Mexican population

Approximately 75% of Indo-European patients with recessive ataxia are homozygous for frataxin gene (FXN) mutations and have either typical or atypical Friedreich ataxia (FRDA). Our previous analysis of 134 Mexican Mestizo recessive ataxia patients showed that FRDA is relatively uncommon in the Mexican population (10.4%). This article reports the evaluation of the phenotypes of these patients. Over half of the patients with clinical diagnostic criteria for FRDA did not carry FXN mutations, constituting a "FRDA-like" phenotypic subgroup. Analysis of non-FRDA patients revealed a subgroup with early onset recessive cerebellar ataxia and cognitive deficit. These two phenotypic subgroups accounted for approximately 60% of all patients, indicating that the cause for recessive ataxia in the Mexican population is distinct from other populations and remains largely unknown.

Start-up alternatives and performance of an UASB pilot plant treating diluted municipal wastewater at low temperature

Different start-up procedures of an upflow anaerobic sludge bed (UASB) digester were carried out. Start-up without inoculum (experiment A) was delayed for about 120 day. The digester reached 75-85% total suspended solids (TSS) removal, 54-58% total chemical oxygen demand (TCOD) removal and 63-73% biological oxygen demand (BOD5) removal at influent concentrations of 240-340 mg TCODil-1, temperatures of 13.5-15 degrees C and hydraulic retention times (HRT) of 10-11 h. Digested sludge was used as inoculum in experiment B. After the start-up period of 75 days, digester efficiencies were 58%, 41% and 54% for TSS, TCOD and BOD5 removal, respectively, working at 169 mg TCODil-1, temperature of 14 degrees C and HRT of 11 h. The sludge bed developed and stabilised quickly when using a hydraulically adapted inoculum (experiment C), but TCOD and BOD5 removals remained low and volatile fatty acids (VFA) accumulated in the effluent.

[Consequences of heroin consumption: compartmental syndrome and rhabdomyolysis]

Compartment syndrome is a condition in which increased pressure within a limited space compromises tissue perfusion with the development of rhabdomyolysis. The causes can be physical, such as the pressure exerted on an anatomical region, or it can be associated with the consumption of illegal drugs, especially heroin. In this latter case, toxic and immunological mechanisms are involved in the physiopathology. Acute renal failure develops in 30% of cases of rhabdomyolysis. Its treatment includes efficient volume replacement, forcing urinary alkalinization and the administering of furosemide and mannitol, with certain precautions. No benefit has been shown in dopamine. When a heroin addict patient shows a clinical pattern of tumescence of his extremities, with or without a period of unconsciousness, the presence of compartment syndrome is to be suspected.

Effects on development

This chapter will review the effects produced on neural development by maternal consumption of cannabinoids during gestation and lactation, with emphasis in the maturation of several neurotransmitter systems (dopamine, serotonin, opioids, cannabinoids, etc.) and possible modifications in their functional expression at the behavioral or neuroendocrine levels. In addition, we have analyzed the possible existence of a sexual dimorphism in these ontogenic effects of cannabinoids, as well as the possible molecular mechanism underlying such effects. In general, the results discussed support the view that exposure to cannabinoids during critical periods of development produces marked modifications in the functional expression of diverse neuronal systems in adulthood. Furthermore, the functions of endocannabinoids in the brain are large not only in adulthood, but also in the period of prenatal and postnatal development. Thus, endocannabinoids have been reported to be present in early ages and to play a role in the process of brain development: neural proliferation and migration, axonal elongation, synaptogenesis and/or myelogenesis.

Benefits of recombinant activated factor VII in complicated liver transplantation

INTRODUCTION

Recombinant activated factor VII (rFVIIa, NovoSeven, NovoNordiskA/S, Bagsvaerd, Denmark) has shown benefits in hemophilic patients and recently in transplant recipients. This study presents our experiences with rFVIIa in complicated liver transplant recipients.

METHODS

From May 2001 to August 2004, rFVIIa was administered to 7 patients undergoing liver transplantation. All treatments were made on emergency bases, except for 1 case with hemophilia A, who received prophylactic treatment. The drug was delivered when severe bleeding with coagulopathy persisted despite the usual treatment with blood products. The drug doses were 60-90 mug/kg; the results were evaluated clinically and analytically.

RESULTS

Seven patients undergoing liver transplantation were treated with FVIIa. Mean prothrombin times before and after treatment were 17.5 and 10.9 seconds, respectively, with a mean reduction of 7.2 seconds (P = .03). Mean thromboplastin times before and after treatment were 38.1 and 29.4 seconds, respectively, with a mean reduction of 8.7 seconds (P = .034). The average dose was 83.6 mug/kg, leading to decreased consumption of blood products (P < .01). In all cases, rFVIIa allowed sufficient hemostasis to carry on definitive treatment. There was no mortality in this series.

CONCLUSIONS

These results provide new evidence on the potential benefits of rFVIIa in liver transplantation, especially for rescue therapy in cases of severe bleeding.

Steroid-free immunosuppression for pancreas-after-liver transplantation

Simultaneous pancreas-kidney transplantation is presently a well-accepted procedure for patients with type 1 diabetes mellitus and renal failure. However, experiences with combined pancreas and liver transplantation are scarce, a few data are available about the best immunosuppression for these patients. We report our experience with two patients who received a pancreas after liver transplantation for long-standing insulin-dependent diabetes mellitus, with steroid-free immunosuppression based on daclizumab, tacrolimus, and mycophenolate mofetil. Short- and long-term evolution was uneventful. Currently, both patients are insulin free with appropriate metabolic control after 12 and 6 months follow-up. Considering our preliminary results, we suggest a steroid-free immunosuppressive regimen as an option for pancreas-after-liver transplantation.

Roles for redox regulation in leaf senescence of pea plants grown on different sources of nitrogen nutrition

Leaf senescence and associated changes in redox components were monitored in commercial pea (Pisum sativum L. cv. Phoenix) plants grown under different nitrogen regimes for 12 weeks until both nodules and leaves had fully senesced. One group of plants was inoculated with Rhizobium leguminosarum and grown with nutrient solution without nitrogen. A second group was not inoculated and these were grown on complete nutrient solution containing nitrogen. Leaf senescence was evident at 11 weeks in both sets of plants as determined by decreases in leaf chlorophyll and protein. However, a marked decrease in photosynthesis was observed in nodulated plants at 9 weeks. Losses in the leaf ascorbate pool preceded leaf senescence, but leaf glutathione decreased only during the senescence phase. Large decreases in dehydroascorbate reductase and catalase activities were observed after 9 weeks, but the activities of other antioxidant enzymes remained high even at 11 weeks. The extent of lipid peroxidation, the number of protein carbonyl groups and the level of H(2)O(2) in the leaves of both nitrate-fed and nodulated plants were highest at the later stages of senescence. At 12 weeks, the leaves of nodulated plants had more protein carbonyl groups and greater lipid peroxidation than the nitrate-fed controls. These results demonstrate that the leaves of nodulated plants undergo an earlier inhibition of photosynthesis and suffer enhanced oxidation during the senescence phase than those from nitrate-fed plants.

356 BLASTOCYST DEVELOPMENT FROM DOMESTIC CAT OOCYTES INJECTED WITH DEHYDRATED SPERMATOZOA

Live offspring have been produced by intracytoplasmic sperm injection (ICSI) of dehydrated spermatozoa into mouse and rabbit oocytes (Wakayama and Yanagimachi 1998 Nature Biotechnol. 16, 639; Liu et al. 2004 Biol. Reprod. 70, 1776). The objective of the present study was to determine the capability of dehydrated domestic cat spermatozoa to fertilize oocytes after ICSI. Spermatozoa were collected from three toms by ejaculation into an artificial vagina. Freshly collected samples were layered under 1 mL of Tyrode's salt solution supplemented with HEPES, BSA, glutamine, pyruvate, lactate, and 50 mM ethyleneglyeotetraacetic acid (EGTA) pH = 8.2-8.4, and allowed to swim-up during a 12-min incubation at 38�C. From the upper 600 �L of the sperm suspension, four 100-�L aliquots were collected and placed into 2-mL glass ampoules, plunged into liquid nitrogen (LN2), freeze dried at -43�C to -45�C and 44 to 76 � 10-3 mbar pressure, and stored at 4�C. Four to twelve 10-�L aliquots of the same suspension were placed onto glass slides, air-dried for 30 min, and stored in a desiccator at room temperature. Domestic cat oocytes were collected from minced ovaries and allowed to mature in vitro for 22 to 24 h. After maturation, oocytes were either fertilized in vitro (IVF; n = 36), or sperm injected (ICSI) with fresh or refrigerated (n = 74), freeze-dried (n = 45), or air-dried (n = 45) spermatozoa. After ICSI or IVF, oocytes were cultured in a three-step-sequential medium (G�mez et al. 2004 Cloning Stem Cells 6, 247) for up to 8 days. Cleavage and development to the blastocyst stage was assessed on Days 2 and 8 of culture, respectively. Cleavage rates after IVF (56%), ICSI with freeze-dried (60%), or ICSI with fresh spermatozoa (59%) were higher than those obtained after ICSI with air-dried spermatozoa (35%; P < 0.05). Blastocyst development after ICSI treatments was obtained only with fresh spermatozoa (9%), and was lower than that obtained after IVF (25%; P < 0.05). Recently, one hatching blastocyst was produced when oocytes (n = 18) were exposed to calcium ionophore 2 h after ICSI with freeze-dried sperm. This is the first report that domestic cat embryos can be produced in vitro by injecting oocytes with dried spermatozoa.

Aquatic degradation of triclosan and formation of toxic chlorophenols in presence of low concentrations of free chlorine

The degradation of 2-(2,4-dichlorophenoxy)-5-chlorophenol (triclosan) in chlorinated water samples was investigated. Sensitive determination of the parent compound and its transformation products was achieved by gas chromatography with mass spectrometry detection after sample concentration, using a solid-phase extraction sorbent and silylation of the target compounds. Experiments were accomplished using ultrapure water spiked with chlorine and triclosan concentrations in the low mg/l and ng/ml ranges respectively. Chlorination of the phenolic ring and cleavage of the ether bond were identified as the main triclosan degradation pathways. Both processes led to the production of two tetra- and a penta-chlorinated hydroxylated diphenyl ether, as well as 2,4-dichlorophenol. The formation of 2,3,4-trichlorophenol was not detected in any experiment; however, significant amounts of 2,4,6-trichlorophenol were noticed. All of these five compounds were also identified when triclosan was added to tap-water samples with free chlorine concentrations below 1 mg/l. Minor amounts of three di-hydroxylated phenols, containing from one to three atoms of chlorine in their structures, were also identified as unstable triclosan chlorination by-products. The analysis of several raw wastewater samples showed the co-existence of important concentrations of triclosan and its most stable by-products (2,4-dichlorophenol and 2,4,6-trichlorophenol), reinforcing the potential occurrence of the described transformations when products containing triclosan are mixed with chlorinated tap water.

[Usefulness of relaxation techniques for patients with ischaemic cardiopathy: intervention in a health district]

OBJECTIVE

To determine the effectiveness of a programme of relaxation used in primary care for patients with ischaemic cardiopathy (IC) through evaluation of the anxiety levels and the quality of life of these patients.

DESIGN

Controlled intervention study without randomisation.

SETTING

Two primary care teams in the city of Sabadell.

PARTICIPANTS

Patients from 15 to 69 years old with IC: intervention group (IG), 57 patients; control group (CG), 47. Interventions. In the IG, conventional treatment and relaxation techniques (RT). In the CG, conventional treatment.

MAIN MEASUREMENTS

Degree of anxiety was measured by means of the STAI scale-questionnaire. Quality of life was measured by means of the SF-36 health questionnaire. Blood pressure and smoking were recorded.

RESULTS

At 12 months, 70% of patients practised relaxation at least for a short time. In the IG, anxiety dropped significantly at 3, 6, and 12 months, especially the anxiety characteristics scale, which was still significant at 12 months (P=.002). Quality of life at 3 and 6 months in the IG showed better scores in most dimensions except body pain. At 12 months, scores continued to be better than at the start (social function P=.012), except in the mental health dimension. No significant changes were found in blood pressure or tobacco consumption.

CONCLUSIONS

Our results suggest that an RT workshop in primary care is beneficial if correctly applied and leads to improved quality of life.

In vitro activity of tigecycline against Bacteroides species

OBJECTIVES

To ascertain the current susceptibility patterns of members of the Bacteroides fragilis group in our hospital and to assess the in vitro activity of tigecycline against these organisms.

METHODS

A total of 400 non-duplicate clinical isolates of the B. fragilis group collected from 2000 to 2002 were studied. Susceptibility testing was performed according to the reference agar dilution method described by the NCCLS. The following antimicrobials were tested: tigecycline, clindamycin, metronidazole, chloramphenicol, cefoxitin, imipenem, amoxicillin-clavulanate and piperacillin-tazobactam.

RESULTS

All strains were susceptible to metronidazole and chloramphenicol. For clindamycin and cefoxitin, the overall susceptibility rates were 59.5% and 83%, respectively. Imipenem and piperacillin-tazobactam were the most active beta-lactam agents tested. Tigecycline inhibited 89.8% of the strains at a concentration of 8 mg/L with an MIC range of <or=0.01 to >16 mg/L. By comparing the MIC50 and MIC90 values of tigecycline among the various species of the group, B. fragilis, Bacteroides thetaiotaomicron and Bacteroides vulgatus were the most susceptible (MIC50/MIC90s of 0.5-1/8 mg/L).

CONCLUSIONS

Tigecycline exhibited activity against most isolates of the B. fragilis group tested. These results indicate that tigecycline may be useful in the treatment and prophylaxis of infections involving these organisms.

Kidney-Pancreas Transplants: Is It So Difficult to Start a Program?

BACKGROUND

For selected patients with type 1 diabetes mellitus and end-stage renal failure, simultaneous kidney-pancreas (SKP) or pancreas after kidney (PAK) transplantation is the treatment of choice. However, it is frequently difficult to start a program for fear of serious intraabdominal complications in an immunosuppressed patient. We review our initial experience with these transplantations.

METHODS

Twenty-three patients (20 SKP, 3 PAK) with type 1 diabetes mellitus received transplants between June 2000 and October 2003. All received immunosuppression therapy with thymoglobulin, prednisone, tacrolimus, and mycophenolate mofetil. The operation included portal venous drainage and exocrine enteric drainage. Rejections were biopsy-proved. Cytomegalovirus prophylaxis with gancyclovir was administered.

RESULTS

The mean follow-up is 13 months (range, 1-30 months) for recipients of mean age 39 +/- 7 years (17 men, 6 women). Mean cold ischemia time for kidney was 10.2 +/- 3.9 hours, and for pancreas was 10.5 +/- 3 hours. The rate of initial graft function was 100%. Graft rejection rate was 8%. The repeat laparotomy rate was 53% (12 patients), with a mean of 0.8 procedures per patient (range, 0 to 5). At the end of follow-up, patient survival was 95%, kidney survival was 85%, and pancreas survival was 83%. Patients with a functioning graft were insulin-free, with a mean fasting glucose concentration of 79 +/- 7 mg/dL, hemoglobin A1C of 4.5% (range, 4% to 4.9%) C-peptide of 5.9 ng/mL (range, 2.1 to 12 ng/mL), and a mean serum creatinine level of 1.6 mg/dL (range, 0.9 to 4.6 mg/dL). There was 1 death, due to posttransplantation lymphoproliferative disease confined to the pancreatic graft and abdominal sepsis at 3 months posttransplantation.

CONCLUSIONS

Our results are similar to those of other series of SPK or PAK transplantations: low acute rejection rates, frequent requirement for repeat laparotomy, and good patient and graft survival, permitting an excellent quality of life.

[Management of choledochal cyst: laparotomy or endoscopic]

The most generally accepted therapy of choledochal cyst is cystectomy and biliar derivation by laparotomy. Last years, endoscopic papilotomy by ERCP has been a valuable therapeutic alternative, no only a diagnostic method. In this study, we reviewed five pediatric patients operated in our Deparment in last five years for choledochal cyst. The initial therapy was laparotomy (n=4) and endoscopic papilotomy by ERCP (n=1) This one was made in other Hospital. Follow-up has been between one and five years. All patients are living. Four patients who were operated by laparotomy are asyntomatic. Patient who was treated by ERCP needed a new ERCP in first posoperative month. Five years ago, she had a seriuos acute pancreatitis and we decided laparotomy and biliar derivation. Since laparotomy, she had two new episodes of acute pancreatitis and she has needed a new endoscopic dilatation with ballon by ERCP. She has been asyntomatic for four months. In conclusion, we think laparotomy with biliar derivation is safer than ERCP in management of children with choledochal cyst. ERCP must be reserved to emergency situations before laparotomy or after postoperative complications, never as exclusive therapy.

Behaviour of pharmaceuticals and personal care products in a sewage treatment plant of northwest Spain

Thirteen pharmaceutical and cosmetic compounds have been surveyed along the different units of a municipal sewage treatment plant (STP) to study their fate across each step and the overall removal efficiency. The STP studied corresponds to a population of approximately 100,000 inhabitants located in Galicia (northwest Spain), including three main sections: pre-treatment (coarse and fine screening, grit and fat removal); primary treatment (sedimentation tanks); and secondary treatment (conventional activated sludge). Among all the substances considered (galaxolide, tonalide, carbamazepine, diazepam, diclofenac, ibuprofen, naproxen, estrone, estradiol, ethinylestradiol, roxitromycin, sulfamethoxazole and iopromide), only significant concentrations were found for two musks (galaxolide and tonalide), two antiphlogistics (ibuprofen and naproxen), two natural estrogens (estrone, estradiol), one antibiotic (sulfamethoxazole) and the X-ray contrast media (iopromide), being the other compounds below the quantification level. In the primary treatment, only the fragrances were partly removed, with efficiencies of 20-50% for galaxolide and tonalide. However, the aerobic treatment caused an important reduction in all compounds detected, between 35 and 75%, with the exception of iopromide. The overall removal efficiency of the STP ranged between 70 and 90% for the fragrances, 45 and 70% for the acidic compounds, around 67% for estradiol and 57% for the antibiotic sulfamethoxazole.

Analysis of the genetic structure of endangered bovine breeds from the Western Pyrenees using DNA microsatellite markers

In the Western Pyrenees, three out of four native cattle breeds are in grave danger of extinction. Genetic variation of all four breeds was assessed by analyzing 478 animals using 11 microsatellite markers. A moderate/high within-breed variability was found, a favorable factor to consider when planning conservation and improvement programs. Interestingly, the only selected commercial breed, the Pirenaica, showed depressed heterozygosity levels and a low average number of alleles, perhaps explainable by intensive human selection exacerbated by a bottleneck effect. The Pirenaica also exhibited pronounced genetic differences and was the largest contributor of diversity among the breeds from the Western Pyrenees. Among endangered cattle breeds from this region, our results highlight the singularity of the Betizu. Geographic isolation among herds may be responsible for the large F(IS) value found in the Betizu breed. Lastly, our study suggests that the use of highly selected breeds may be one of the causes of distortion in phylogenetic analyses.

Performance of a UASB-digester system treating domestic wastewater

The anaerobic treatment of raw domestic wastewater by a novel technology consisting of an Up-flow Anaerobic Sludge Bed (UASB) reactor combined with a completely mixed digester for the stabilisation of the UASB sludge was assessed. A pilot-scale plant of the so-called UASB-Digester system was located at the municipal wastewater treatment facility of Santiago de Compostela (Northwest of Spain). The main aim of the Digester was to enhance the biodegradation of influent solids retained in the UASB reactor at low temperatures, then increasing its specific methanogenic activity. The sludge drawn from the middle zone of the UASB entered the upper zone of the Digester and then circulated from the bottom of the Digester to the UASB bottom. Circulating in an automated semi-continuous way, the flow of this sludge stream was selected in order to set a previously defined hydraulic retention time (HRT) (16-27 d) in the digester. The Digester temperature was set at an optimum value ranging from 25 to 35 degrees C. The steady state efficiency of the UASB system, at 6-8 h of HRT, 15-16 degrees C of temperature and 330-360 mg l(-1) of influent total chemical oxygen demand (TCOD) was 79% of total suspended solids (TSS) removal, 52% of TCOD removal and 60% of biological oxygen demand (BOD5) removal. The hydrolysis of retained solids reached 85%, while excess sludge generation was only 7% of influent TCOD. A stable anaerobic (pre)treatment of diluted domestic wastewater was reached as the sludge concentration in the reactor remained mainly constant and the specific methanogenic activity showed a slight increase.

[Experimental model of auxiliary heterotopic liver-intestinal transplantation]

In pigs, orthotopic liver-intestine transplantation (LITX) has high per operative morbidity and mortality. It is due to hemodynamic, coagulation and metabolism disorders during native liver hepatectomy (total hepatic vascular exclusion) and the postoperative diarrhea secondary to initial dysfunction of the graft and enterectomy of native intestine. To avoid those disturbances and to increase the survival, we have developed a porcine model of auxiliary heterotopic LITX. The allograft was harvested in-bloc, containing the liver, duodenum, pancreas, and jejunum. In the recipient, the liver and intestine were left intact. The allograft was implanted heterotopically, caudal to the native liver. Venous drainage was achieved with anastomosis of donor (D) to recipient (R) infrahepatic cava; and arterialization with anastomosis of D aortic conduit containing the celiac axis and SMA to infra-renal R aorta. The D jejunum was hooked-up to R jejunum. The experiment was performed in 16 animals without intraoperative deaths, hemodynamic stability and no blood requirements. Four animals were left alive 7 days with functioning grafts, suggesting the model viability.

In vitro activities of tigecycline against erythromycin-resistant Streptococcus pyogenes and Streptococcus agalactiae: mechanisms of macrolide and tetracycline resistance

The activity of tigecycline was tested against erythromycin-resistant streptococci (107 Streptococcus pyogenes and 98 Streptococcus agalactiae strains). The presence of erythromycin and tetracycline resistance genes was determined by PCR. Among S. pyogenes strains the most prevalent gene was mef(A) (91.6%). The erm(B) gene was the most prevalent (65.3%) among S. agalactiae strains. Tigecycline proved to be very active against all the isolates tested (MIC at which 90% of the isolates tested were inhibited, 0.06 micro g/ml), including those resistant to tetracycline.

[Treatment of pain in the oncology patient]

Pain is a symptom with a high prevalence in patients with cancer and causes an important deterioration in their quality of life. With the measures laid out by the WHO in 1986, which divides the different therapeutic options available in three ascending steps, pain can be controlled in a high percentage of cases. Those patients who are difficult to control with these measures can benefit from the application of neuromodulation techniques by experts in the treatment of chronic pain. The correct employment of the different medicines (non-steroidal anti-inflammatory medicines, opiates and coadjuvants), knowledge of the secondary effects, loss of fear in the face of opiates and knowledge of the different algic syndromes associated with the oncology patient, must be accompanied by a suitable evaluation of the pain according to the different scales, both in the phase of the treatment's initiation and in the follow-up of the patient.

Comparison of the predation rate of freshwater cyclopoid copepod species on larvae of the mosquito Culex pipiens

The predation rates of six copepod species: Acanthocyclops robustus G.O. Sars, Eucyclops neumani Pesta, Macrocyclops albidus Jurine, Mesocyclops longisetus Thibaud, Metacyclops grandis Kiefer and Metacyclops mendocinus Wierzejski (Copepoda: Cyclopidae) on mosquito larvae, Culex pipiens Linnaeus (Diptera: Culicidae) were assessed. Experiments consisted of 24-h incubations of one copepod and 10 larvae without extra food at 16 degrees C and 26 degrees C. Nine replicates were considered for each species and temperature. Predation rates (larvae per copepod per day) were: M. mendocinus (1.8), M. grandis (3.1), E. neumani (3.8), A. robustus (3.8), Ma. albidus (6.1) and Me. longisetus (7.0). There was a significant effect of both species and temperature on predation: all species experienced higher predation at 26 degrees C than at 16 degrees C, except for A. robustus whose predation rate was similar at both temperatures. These observations are consistent with previous results that point to Macrocyclops and Mesocyclops genera as important larval predators and suggest the need for field trials to evaluate the response of Ma. albidus and Me. longisetus under natural conditions in Uruguay.

Liver transplantation for peripheral cholangiocarcinoma: Spanish experience

INTRODUCTION

Palliative treatment for nondisseminated unresectable peripheral cholangiocarcinoma (PCC) carries a 0% 5-year survival rate. The role of orthotopic liver transplantation (OLT) in these patients is controversial because the survival rate is lower than with other indications for transplantation and the lack of available donor organs. The aim of this paper was to review the Spanish experience in OLT for PCC to identify prognostic factors for survival.

METHODS

We retrospectively reviewed 23 patients undergoing OLT in Spain for PCC over a period of 13 years.

RESULTS

The actuarial survival rates were 77%, 65%, and 42% at 1, 3, and 5 years, respectively. The main cause of death was tumor recurrence (35%). Prognotic factors for an adverse outcome were pTNM classification (P<.05) in the univariate analysis and perineural invasion (P<.05) and stages III or IVA (P<.05) in the multivariate analysis.

CONCLUSIONS

OLT for nondisseminated irresectable PCC displays higher survival rates at 3 and 5 years than palliative treatments, especially for tumors in the initial stages, which means that more information is needed to help better select PCC patients for transplantation.

Liver transplantation for hilar cholangiocarcinoma: Spanish experience

INTRODUCTION

Palliative treatment for nondisseminated irresectable hilar cholangiocarcinoma (HCC) carries a 0% 5-year survival rate. The role of orthotopic liver transplantation (OLT) in these patients is controversial because the survival rate is lower than that for other indications for transplantation and the lack of available donor organs. The aim of this paper was to review the Spanish experience in OLT for HCC and identify prognostic factors for survival.

METHODS

We retrospectively reviewed 36 patients undergoing OLT for HCC over 13 years.

RESULTS

The actuarial survival rate at 1, 3, and 5 years was 82%, 53%, and 30%, respectively. The main cause of death was tumor recurrence (53%). In the univariate analysis, the factors for a poor prognosis were vascular invasion (P<.001) namely 0% survival at 3 years when present versus 63% and 35% at 3 and 5 years, respectively, when it was not; and stages III to IVA (P<.05), namely 15% survival at 5 years versus 47% for stages I to II. Lymph node and perineural invasion also reduce survival. In the multivariate analysis, the factors for poor prognosis included vascular invasion (P<.01) and stages III to IVA (P<.01).

CONCLUSION

OLT for nondisseminated irresectable HCC has higher survival rates at 3 and 5 years than palliative treatments, especially with initial stage tumors, which means that more information is needed to better select cholangiocarcinoma patients for transplantation.

Aluminum-induced pro-oxidant effects in rats: protective role of exogenous melatonin

In recent years, it has been suggested that oxidative stress is a feature of Alzheimer's disease in which aluminum (Al) could exacerbate oxidative events. The goal of the present study was to assess in rats the pro-oxidant effects induced by Al exposure, as well as the protective role of exogenous melatonin. Two groups of male rats were intraperitoneally injected with Al only or melatonin only, at doses of 5 and 10 mg/kg/day, respectively for 8 wk. During this period, a third group of animals received Al (5 mg/kg/day) and melatonin (10 mg/kg/day). At the end of the treatment period, rats were anesthesized and arterial blood was obtained. Thereafter, animals were killed and liver and brain (cortex, hippocampus and cerebellum) were removed. These tissues were processed to examine oxidative stress markers: glutathione transferase (GST), reduced glutathione (GSH), oxidized glutathione (GSSG), superoxide dismutase (SOD), glutathione reductase (GR), glutathione peroxidase (GPx), catalase (CAT), thiobarbituric acid reactive substances (TBARS), as well as protein content. Samples of these tissues were also used to determine Al, Fe, Mn, Cu and Zn concentrations. The results show that Al exposure promotes oxidative stress in different neural areas, including those in which Al concentrations were not significantly increased. The biochemical changes observed in neural tissues show that Al acts as pro-oxidant, while melatonin exerts an antioxidant action in Al-treated animals. The protective effects of melatonin against cellular damage caused by Al-induced oxidative stress, together with its low toxicity, make melatonin worthy of investigation as a potential supplement to be included in the treatment of neurological disorders in which the oxidative effects must be minimized.

[Perinatal factors associated with attention deficit/hyperactivity diagnosis in Colombian Paisa children]

INTRODUCTION

Some perinatal factors have been associated with attention d ficit/hyperactivity disorder (ADHD).

OBJECTIVE

To estimate the association between perinatal factor and ADHD diagnosis in school, aged 6 to 11 years, children from Medell n city (Colombia).

PATIENTS AND METHODS

A randomized sample of 200 cases, 6 to 11 year old, with standardized ADHD diagnosis was selected. A randomized sample of 200 control children, 6 to 11 year old, was selected from a data base of 70 schools of Medell n city. The same diagnostic protocol was administered to controls. A questionnaire with questions about pregnancy, delivery an neonatal period was given to the mothers. Data were analyzed using cross tabulation and stepwise logistic multiple regression analyses.

RESULTS

Miscarriage symptoms, premature delivery symptoms, severe flu attacks (cold with fever, without virus confirmation), tobacco abuse, alcohol abuse (to become drunk), minor congenital malformations, neonatal seizures and hospitalizations during newborn period were factors associated with ADHD diagnosis (p< 0.05). However, stepwise logistic multiple regression analysis selected a block of variables formed by premature delivery symptoms, severe flu attacks and neonatal seizures as significant perinatal risk factors (p< 0.01) for ADHD diagnosis.

Erythromycin and clindamycin resistance and telithromycin susceptibility in Streptococcus agalactiae

The rates of resistance to erythromycin and clindamycin among Streptococcus agalactiae strains isolated in our hospital increased from 4.2 and 0.8% in 1993 to 17.4 and 12.1%, respectively, in 2001. Erythromycin resistance was mainly due to the presence of an Erm(B) methylase, while the M phenotype was detected in 3.8% of the strains. Telithromycin was very active against erythromycin-resistant strains, irrespective of their mechanisms of macrolide resistance.

[Benefit of scanning laser ophthalmoscopy for detecting retinal nerve fiber layer defects in patients with intraocular hypertension]

PURPOSE

To compare the ability to identify RNFL alterations between standard images and SLO images in a group of patients suffering from ocular hypertension.

METHODS

We evaluated RNFL in sixty patients with ocular hypertension and with normal perimetry, by using standard photography and SLO. Two different independent observers evaluated the images on two different ocassions.

RESULTS

We studied 118 eyes, twelve eyes were rejected because of the low quality of the images. Four cases of diffuse atrophy and five patients with wedge shaped defects were observed using both methods. Statistical analysis showed no differences between both exploration techniques or between observers.

CONCLUSIONS

RNFL study with SLO seems to be at least as reliable as standard photography as a method to evaluate RNFL defects. SLO has also proved to be much easier, and faster than traditional methods.

Anaerobic hydrolysis of a municipal wastewater in a pilot-scale digester

Raw domestic wastewater from the city of Santiago de Compostela (Northwest Spain) was fed into a pilot-scale hydrolytic up flow sludge bed (HUSB) digester with an active volume of 25.5 m3. The total influent chemical oxygen demand (COD) ranged from 360 to 470 mg/l, the influent SS varied from 190 to 370 mg/l, and the temperature was between 17 degrees and 20 degrees C. The organic load rate (OLR) applied increased step by step from 1.2 to 3.9 kgCOD/m3 x d, while the hydraulic retention time (HRT) decreased from 7.1 h to 2.9 h. A high suspended solids (SS) removal of about 82-85% from the influent was reached, most of which (81 to 88%) was eliminated by hydrolysis, while the rest remained in the purge stream. The total COD removal ranged from 46 to 59%. On the other hand, a high acidification of the COD remaining in the effluent was obtained, so the percent COD in the form of volatile fatty acids (VFA(COD)) with respect to total effluent COD was about 43% for the highest HRT applied, and about 27% for the lowest HRT. The soluble to total COD ratio (CODs/CODt) increased from 25-32% for the influent to 71-86% for the effluent. The results obtained confirm the viability and interest of direct anaerobic hydrolytic pre-treatment of domestic wastewater.

Levels and risk assessment for humans and ecosystems of platinum-group elements in the airborne particles and road dust of some European cities

Traffic is the main source of platinum-group element (PGE) contamination in populated urban areas. There is increasing concern about the hazardous effects of these new pollutants for people and for other living organisms in these areas. Airborne and road dusts, as well as tree bark and grass samples were collected at locations in the European cities of Göteborg (Sweden), Madrid (Spain), Rome (Italy), Munich (Germany), Sheffield and London (UK). Today, in spite of the large number of parameters that can influence the airborne PGE content, the results obtained so far indicate significantly higher PGE levels at traffic sites compared with the rural or non-polluted zones that have been investigated (background levels). The average Pt content in airborne particles found in downtown Madrid, Göteborg and Rome is in the range 7.3-13.1 pg m(-3). The ring roads of these cities have values in the range 4.1-17.7 pg m(-3). In Munich, a lower Pt content was found in airborne particles (4.1 pg m(-3)). The same tendency has been noted for downtown Rh, with contents in the range 2.2-2.8 pg m(-3), and in the range 0.8-3.0 and 0.3 pg m(-3) for motorway margins in Munich. The combined results obtained using a wide-range airborne classifier (WRAC) collector and a PM-10 or virtual impactor show that Pt is associated with particles for a wide range of diameters. The smaller the particle size, the lower the Pt concentration. However, in particles <PM-10, some of the highest values correspond to the fraction <0.39 microm. Considering an average Pt content in all particles of approximately 15 pg m(-3), which is representative for all countries and environmental conditions, the tracheobronchial fraction represents approximately 10% and the alveolar fraction approximately 8% of the total particles suspended in air. However, from the environmental risk point of view, an exposure to PGEs in traffic-related ambient air is at least three orders of magnitude below the levels for which adverse health effects might theoretically occur (of approx. 100 ng m(-3)). Therefore, today inhalation exposure to PGEs from automotive catalysts does not seem to pose a direct health risk to the general population. Even though the data available today indicate no obvious health effects, there are still a number of aspects related to PGEs and catalysts that justify further research. First, continual monitoring of changes in PGE levels in air and road dust is warranted, to make sure that there is no dramatic increase from today's levels. Secondly, more detailed information on the chemical composition of the PGE-containing substances or complexes leaving the catalyst surface and the size distribution of the PGE-containing particles released during driving will facilitate a more in-depth human risk assessment.