A real-life overview of a hematopoietic cell transplant program throughout a four-year period, including prospective registry, exclusion causes and final donor selection

Traceability of patients who are candidates for Hematopoietic cell transplant (HCT) is crucial to ensure HCT program quality. Continuous knowledge of both a detailed registry from a HCT program and final exclusion causes can contribute to promoting a real-life vision and optimizing patient and donor selection. We analyzed epidemiological data reported in a 4 year-monocentric prospective registry, which included all patients presented as candidates for autologous (Auto) and/or allogeneic (Allo) HCT. A total of 543 patients were considered for HCT: 252 (42.4%) for Allo and 291 (57.6%) for Auto. A total of 98 (38.9%) patients were excluded from AlloHCT due to basal disease progression more commonly (18.2%). Seventy-six (30.2%) patients had an HLA identical sibling, whereas 147 (58.3%) patients had only Haplo. UD research was performed in 106 (42%) cases, significantly more often in myeloid than lymphoid malignancies (57% vs 28.7%, p < 0.001) but 61.3% were finally canceled, due to donor or disease causes in 72.4%. With respect to Auto candidates, a total of 60 (20.6%) patients were finally excluded; progression was the most common cause (12%). Currently, Haplo is the most frequent donor type. The high cancellation rate of UD research should be revised to optimize further donor algorithms.

Performance of SARS-CoV-2 rapid antigen test compared with real-time RT-PCR in asymptomatic individuals

Screening, testing and contact tracing plays a pivotal role in control of the COVID-19 pandemic. To enable this it is necessary to increase the testing capacity. This study compared a SARS-CoV-2 rapid antigen test (RAT) and RT-PCR in 842 asymptomatic individuals from Tarapacá, Chile. A sensitivity of 69.86%, specificity of 99.61%, PPV of 94.44% and NPP of 97.22% with Ct values (Ct > 27) that were significantly higher among individuals with false-negative RAT were reported. These results support the fact that RAT might have a significant impact on the identification of asymptomatic carriers in areas that lack suitable laboratories to perform SARS-CoV-2 real-time RT-PCR diagnostics, or the results take more than 24-48 h, as well as zones with high traffic of individuals such as border/customs, airports, interregional bus, train stations or in any mass testing campaign requiring rapid results.

The change of teeth color, whiteness variations and its psychosocial and self-perception effects when using low vs. high concentration bleaching gels: a one-year follow-up

Background

Dental bleaching in traditional concentrations generates greater sensitivity. In this respect, new systems of lower concentration of hydrogen peroxide for tooth bleaching appeared, with color stability unknown over time. The aim of this study was to compare the change and stability of color with low-concentration (6%) hydrogen peroxide gel in an in-office bleaching setting relative to conventional 37.5% gel, including their effects on psychosocial and esthetic self-perception, after 1 year.

Methods

Patients (n = 25) were assessed at 12 months post bleaching treatment (whitening with 6% chemo-activated alkaline formula gel versus 37.5% traditional concentration gel). Color changes were measured objectively using total variation in color (ΔE), and subjectively using Vita Classical and Vita Bleached scale (ΔSGU) by calibrated evaluators (Kappa = 0.85). The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Oral Health Impact Profile (OHIP-14) aesthetic questionnaires were used to measure the self-perception and the psychosocial impact of the bleaching protocols.

Results

The effect (ΔE) of 37.5% HP (8.37 ± 2.73) was significantly better than that of 6% HP (5.27 ± 2.53) in terms of color rebound after 1 year of follow-up. There were significant differences in psychosocial impact and esthetic self-perception measurements prior to bleaching versus one-year post-whitening time points; positive effects were maintained.

Conclusions

Low concentration (6%) achieved effective bleaching with good stability after 1 year, accompanied by a positive psychosocial impact and enhanced self-perception at follow-up.

Trial registration

NCT03217994 (before enrollment of the first participant). Data register: July 14, 2017.

When reporting Nocardia spp is not enough. Brain abscess caused by Nocardia farcinica

Abscesses caused by the genus Nocardia spp are relatively rare, accounting for approximately 2 % of all brain abscesses, but with a significantly higher mortality. Special stains of brain abscess material from a 60-year-old man showed Gram-positive branching bacilli and the presence of long, acid-fast branching filamentous bacilli suggesting Nocardia infection. Presented here is a case of multidisciplinary management of a patient who developed cerebral abscesses by Nocardia farcinica, confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), that was susceptible to trimethoprim/sulfamethoxazole, linezolid, imipenem and not susceptible to minocycline. This case highlights the importance of performing subtyping and antimicrobial testing in order to improve clinical and treatment outcomes due to patterns of antibiotics resistance among Nocardia species.

Target Strength and swimbladder morphology of Mueller's pearlside (Maurolicus muelleri)

In the last few years, there has been increasing interest in the commercial exploitation of mesopelagic fish and a trawl-acoustic methodology has been recommended to make estimates of abundance of these resources. This study provides relevant information on the scattering properties of a key mesopelagic fish species in the Bay of Biscay, Mueller's pearlside (Maurolicus muelleri), necessary to convert the acoustic density into numerical abundance. The target strength (TS) of pearlside was estimated for the first time at five frequencies commonly used in acoustic surveys. A high-density filter was applied to reduce the bias derived from overlapping echoes erroneously assigned to single targets. Its relationship with fish length (b20) was also determined (-65.9 ± 2, -69.2 ± 3, -69.2 ± 2, -69.5 ± 2.5 and -71.5 ± 2.5 dB at 18, 38, 70, 120 and 200 kHz, respectively). Biomass estimates of pearlside in the Bay of Biscay during the four years of study (2014-2017) are given using the 38 kHz frequency. Morphological measurements of the swimbladder were obtained from soft X-ray images and used in the backscattering simulation of a gas-filled ellipsoid. Pearlside is a physoclist species, which means that they can compensate the swimbadder volume against pressure changes. However, the best fit between the model and the experimental data showed that they lose that capacity during the trawling process, when the swimbladder volume is affected by Boyle's law.

Vertical distribution and aggregation patterns of krill (Crustacea: Euphausiacea) in the Bay of Biscay: interannual and seasonal variability

Studies of krill (Crustacea: Euphausiacea) in oceanic waters of the Bay of Biscay are scarce and restricted to the epipelagic zone, overlooking vertical dynamics such as diurnal vertical migration (DVM). There is a growing interest in acoustically evaluating the biomass of krill in this area, but this requires a good knowledge of its vertical dynamics and aggregation patterns. In this work we employed acoustic data and net samples from two consecutive annual surveys covering a wide off-shelf area of the Bay of Biscay (JUVENA surveys of 2013 and 2014) and four seasonal surveys covering slope and oceanic waters in the Cantabrian Sea (SCAPA surveys of 2015). Vertical dynamics of krill were analyzed in the frame of the environmental seascape. High interannual and seasonal variations in the vertical distribution and aggregation patterns (small swarms, dense aggregations, or loose layers) of krill were observed. The vertical distribution covaried with dissolved oxygen and salinity. According to our findings, the best season to acoustically evaluate krill in the Bay of Biscay is spring, with the bulk of the biomass located above 600 m depth. Moreover, extending the acoustic recording beyond the epipelagic zone is mandatory for any season.

Effectiveness of Dental Bleaching With 37.5% and 6% Hydrogen Peroxide and Its Effect on Quality of Life

Objective:

This study investigated whether it is possible to achieve equally satisfactory results between 37.5% hydrogen peroxide (HP) gel and 6% HP gel. We also assessed the psychosocial impact and self-perception of esthetics generated by extracoronal tooth whitening.

Methods and Materials:

A prospective, double-blind, randomized clinical trial was carried out. A total of 33 patients were selected from the clinic of the Faculty of Dentistry at the University of Chile. The patients included men and women over 18 years old without prior tooth whitening treatments, tooth decay, or restorations of the maxillary anterior teeth. The patients had tooth colors of A3 or less according to the Vita Classical scale, which was determined with a Vita Easy Shade spectrophotometer. The study was carried out with a “split-mouth” design. One side of each mouth was randomly treated with 37.5% HP, and the other side was bleached with 6% HP. Each group received 3 to 12 minutes of treatment with the respective gel applications. Two sessions of bleaching were carried out each week. A spectrophotometer was used to measure the total variation of color (ΔE), and a subjective evaluation was made with Vita Classical scale (ΔSGU) between the baseline (session 1) and different measurement times. We compared ΔE and ΔSGU for both agents using the Mann-Whitney test (α=0.05).

Results:

In both groups, there was variation among the initial color and the color in the different measurement times. In the month after the treatment was completed, ΔE was 9.06 in the 37.5% HP group and 5.69 in the 6% HP group. The difference between the two groups was statistically significant starting in the second session (p=0.000).

Conclusion:

There was a significant difference between the effectiveness of the bleaching gel concentrations of 37.5% and 6% HP according to spectrophotometer measurements and subjective evaluations. There was also a positive effect on psychosocial impact and esthetic self-perception among patients.

EL NIÑO PROBLEMA DEL CHILE DICTATORIAL SEGÚN UNA REVISTA FEMENINA

Resumen Este artículo tiene como objetivo dar cuenta de la relación compleja entre el niño problemático y la mujer como cuidadora y responsable, así como la relación entre las nociones de niño problemático y el cuadro del Trastorno de Déficit Atencionales, desde una perspectiva discursiva crítica. Para ello se revisaron discursos relacionados al niño problema que las disciplinas Psi desarrollaron en una revista femenina de alta circulación en Chile, durante los años 1983 y 1989. Entre los resultados se encuentran cómo mujeres y niños quedan del lado de la dominación y subalternidad de lo adulto masculino y las disciplinas Psi, donde los cuerpos disciplinados toman un lugar preponderante. Se finaliza con una hipótesis acerca del rol protector del diagnóstico psi en el entorno violento de la dictadura.

Cytokine distribution in mothers and breastfed children after omega-3 LCPUFAs supplementation during the last trimester of pregnancy and the lactation period: A randomized, controlled trial

OBJECTIVE

To determine whether maternal diet supplementation with omega-3 long chain polyunsaturated fatty acids (omega-3 LC-PUFAs) during the last trimester of pregnancy and the breastfeeding period influences the levels of inflammatory cytokines in mother and infants.

MATERIAL AND METHOD

This registered, double-blind randomized study included 46 pregnant women, who were randomly allocated to either an experimental group receiving 400mL/day of a fish oil-enriched dairy drink [320mg docosahexaenoic acid (DHA) + 72mg eicoapentaenoic acid] (FO group, n = 24) or to a control group receiving 400mL/day of a non-supplemented dairy drink (CT group, n = 22), from week 28 of pregnancy until the fourth month of lactation. During the study, maternal dietary patterns were monitored by a nutritionist, who encouraged compliance with current recommendations of fatty acids intake. DHA concentrations and cytokine levels (GM-CSF, IL-2, IL-4, IL-6, IL-10, INF-γ and TNF-α) were measured in maternal plasma at the moment of recruitment and in maternal (n = 46) and infant (n = 46) plasma at birth and 2.5 months after birth.

RESULTS

Maternal plasmatic IL-4 levels were higher in FO than in CT subjects (p = 0.009). Additionally, a tendency was observed to higher IL-10 and IL-2 in the FO group. Plasmatic IL-6 however, was higher in CT mothers (p = 0.001). TNF-α was higher in CT infants at birth and 2.5 months after birth (p = 0.005). An analysis of possible relationships between DHA and the concentrations of different cytokines revealed negative correlation between maternal plasmatic IL-6 and DHA (higher plasmatic DHA corresponded to lower IL-6).

CONCLUSIONS

Maternal dietary omega-3 LC-PUFAs supplementation during critical periods like pregnancy, lactation and early newborn development may influence the levels of certain inflammatory cytokines, reducing pro-inflammatory cytokines and promoting an anti-inflammatory "environment".

[BK and JC polyomavirus detection in leukocyte extracts of peripheral blood samples of HIV+ patients from the north area of Santiago]

INTRODUCTION

Polyomavirus BK (BKPyV) and JC (JCPyV) are persistent pathogens able to reactivate in im-munocompromised patients, involving mostly urinary and central nervous system. There are no Chilean studies in HIV positive patients.

OBJECTIVE

To detect BKPyV and JCPyV in blood of Chilean HIV positive adult patients and to correlate these results with clinical-related variables.

MATERIALS AND METHODS

96 stored blood samples from HIV patients belonging to the north area of Santiago were analyzed. Viral genomes of both viruses were detected by real-time PCR. For statistical analysis, chi-square (Pearson) and Mann-Whitney tests were used and p-values < 0.05 were considered significant.

RESULTS

33% of the samples were positive for BKPyV and a significant correlation was found between the presence of BKPyV genome and the absence of detectable HIV viral load. We demonstrated the need to consider more than one amplification target to detect the BKPyV genome. All the samples were negative for JCPyV genome.

DISCUSSION

BKPyV prevalence in Chilean HIV patients is higher than most of international studies. New studies regarding the interaction between both viruses are required. These patients should undergo periodic evaluations by urologist and nephrologist.

Clinical disease activity and titers of anti-dsDNA antibodies measured by an automated immunofluorescence assay in patients with systemic lupus erythematosus

Autoantibodies specific for double stranded DNA (anti-dsDNA Abs) are a serological biomarker of systemic lupus erythematosus (SLE) and constitute useful tools for monitoring many SLE patients. A new automated immunofluorescence and quantitative assay (EliA dsDNA) has recently become available. Its performance has been demonstrated to be equivalent to the Farr and Crithidia luciliae fluorescence (CLIFT) tests. The aim of the present work was to assess the utility of this new assay to monitor clinical activity in a large cohort of SLE patients. To this end, 1020 sera from 181 SLE patients were evaluated by the two methods. Results showed a higher frequency of positive results of anti-dsDNA Abs during lupus flares measured by EliA dsDNA than by CLIFT. Likewise, titers of those Abs were significantly increased in active SLE in comparison with inactive SLE when measured by EliA dsDNA but not by CLIFT. Serum titers of anti-dsDNA Abs by both assays showed a significant negative association with concentrations of C3 and C4. In summary, this retrospective study on a large cohort of patients demonstrated that EliA dsDNA was at least as useful as CLIFT as monitoring tool in the follow-up of SLE patients, but with the advantages of being automated, quick and quantitative.

A novel configuration for an anaerobic submerged membrane bioreactor (AnSMBR). Long-term treatment of municipal wastewater under psychrophilic conditions

A novel design for a pilot scale anaerobic submerged membrane bioreactor (AnSMBR) equipped with an ultrafiltration unit, treating municipal wastewater at 18 ± 2°C, and inoculated with a mesophilic inoculum without acclimation, was implemented and evaluated over 3 years of stable operation. The AnSMBR operated with a volumetric loading rate between 1.6 to 2.0 kg COD/m(3)UASBd, 12.8 to 14.2h hydraulic retention time, and reached a tCOD removal efficiency of around 90%. Biosolid production was between 0.05 and 0.083 g VS/g CODremoved. Dissolved methane oversaturation in the effluent was observed, reaching average values of 19.1 ± 0.84 mg CH4/L. The permeate flow rate ranged from 10 to 14L/m(2)h with trans-membrane pressure (TMP) values of 400-550 mbar, using cycles of 30s backwash, 7.5 min filtration, and continuous biogas sparging (9-16 m/h). During the three years of continuous operation, the membrane was not physically or chemically cleaned.

Long-term operation of a pilot scale anaerobic membrane bioreactor (AnMBR) for the treatment of municipal wastewater under psychrophilic conditions

The performance of a pilot scale anaerobic membrane bioreactor (AnMBR), comprising an upflow anaerobic sludge blanket (UASB) reactor coupled to an external ultrafiltration membrane treating municipal wastewater at 18±2°C, was evaluated over three years of stable operation. The reactor was inoculated with a mesophilic inoculum without acclimation. The AnMBR supported a tCOD removal efficiency of 87±1% at hydraulic retention time (HRT) of 7h, operating at a volumetric loading rate (VLR) of between 2 and 2.5kgtCOD/m(3)d, reaching effluent tCOD concentrations of 100-120mg/L and BOD5 concentrations of 35-50mgO2/L. Specific methane yield varied from 0.18 to 0.23Nm(3)CH4/kgCODremoved depending on the recirculation between the membrane module and the UASB reactor. The permeate flow rate, using cycles of 15s backwash, 7.5min filtration, and continuous biogas sparging (40-60m/h), ranged from 10 to 14Lm(2)/h with trans-membrane pressure (TMP) values of 400-550mbar.

Where does the removal of H₂S from biogas occur in microaerobic reactors?

In order to maximise the efficiency of biogas desulphurisation and reduce the oxygen cost during microaerobic digestion, it is essential to know how the process occurs. For this purpose, a reactor with a total volume of 266 L, treating 10 L/d of sewage sludge, was operated with 25.0 L and without headspace. Under anaerobic conditions, the H2S concentration in the biogas varied between 0.21 and 0.38%v/v. Next, O2 was supplied from the bottom of the reactor. At 0.25-0.30 NLO₂/Lfed, the biogas was entirely desulphurised, and its O₂ content remained below 1.03%v/v, when the digester had 25.0 L of gas space. However, with almost no headspace, the H2S content in the biogas fluctuated from 0.08 to 0.21%v/v, while the average O2 concentration was 1.66%v/v. The removed H2S accumulated in the outlet pipe of the biogas in the form of S(0) due to the insufficient headspace.

[Seroprevalence of varicella-zoster virus in children with cancer in six hospitals in Santiago, Chile]

Infections with varicella-zoster virus (VVZ) in immunocompromised children imply a high mortality. There is no data about VVZ seroprevalence in children with cancer in our country.

AIM

To determine the prevalence of VVZ antibodies in children with cancer who have undergone chemotherapy or have undergone a hematopoietic stem cell transplant.

METHODOLOGY

collaborative, multicenter study. Serum samples were collected from 281 children with cancer and episodes of febrile neutropenia from 6 hospitals belonging to the public health network in the Metropolitan Region between June 2004 and August 2006. These samples were stored at -70 ° C, and 200 of them were randomly chosen and analyzed to determine VVZ IgG (ELISA).

RESULTS

179 samples from 179 children, 65% male. Ninety eighth/179 (55%) were positive, 72/179 (40%) negative and 9/179 (5%) indeterminate. Stratified by age, seropositive percentage was: 1 to 4 years 32%, 5-9 years 42%, 10-14 years 78%, over 15 years 88%.

CONCLUSION

Forty percent of children treated for cancer are seronegative to VVZ infection, a frequency that decreases with age. These results support the adoption of preventive measures to avoid infection in this population of children at risk of developing a serious and possibly fatal illness.

Biological decolourisation of wastewater from molasses fermentation by Trametes versicolor in an airlift reactor

Continuous decolourisation of wastewater from molasses fermentation using mycelium of Trametes versicolor in pellets shape was performed in an airlift bioreactor (semi-pilot scale) with the aim of operating steadily for a long period, maintaining the colour removal activity. The influences of influent flow and glucose feed rate were tested. Induction of peroxidases secretion by Mn(2+) addition was also studied. The efficiency of the decolourisation process was followed by monitoring colour and enzymatic activities. The experimental results showed that continuous decolourisation in an airlift bioreactor can be considered a suitable alternative for treating molasses fermentation wastewater. A colour removal yield around 60% remained practically constant during 23 days under continuous operation. Laccase was found to be the main enzyme secreted by the strain, being responsible for the decolourisation process. Mn(2+) addition was not likely to induct manganese-dependent peroxidase secretion.

Kinetic study of ozonation of molasses fermentation wastewater

A kinetic study of molasses wastewater ozonation was carried out in a stirred tank reactor to obtain the rate constants for the decolorization reaction and the regime through which ozone is absorbed. First, fundamental mass transfer parameters such as ozone solubility, volumetric mass transfer coefficients and ozone decomposition kinetics were determined from semi-batch experiments in organic-free solutions with an ionic composition similar that of industrial wastewater. The influence of operating variables such as the stirring rate and gas flow rate on the kinetic and mass transfer parameters was also studied. The application of film theory allows to establish that the reactions between ozone and colored compounds in wastewater take place in the fast and pseudo-first-order regime, within the liquid film. The decolorization rate constants were evaluated at pH 8.7 and 25 degrees C, varying from 0.6 x 10(7) to 3.8 x 10(7)L mol(-1)s(-1), depending on the stirring rate and the inlet gas flow.

Pulmonary toxicity associated with sirolimus treatment in kidney transplantation

INTRODUCTION

An important side effect of sirolimus, a drug often used in organ transplantation, is pulmonary toxicity.

MATERIALS AND METHODS

We present five kidney transplant patients who developed this toxicity associated with sirolimus. All underwent chest radiography computed tomography, fiberoptic bronchoscopy with bronchoalveolar lavage (BAL), microbiological studies of the bronchial aspirate, blood, and sputum, and cytomegalovirus (CMV) polymerase chain reaction (PCR) in blood as well as two had transbronchial biopsies.

RESULTS

All five were men of mean age 54.8 +/- 10.3 years. In two sirolimus formed part of de novo therapy, and three were converted from calcineurin inhibitors. The mean treatment time was 16.6 +/- 13.7 months, with trough levels of 11.3 +/- 3 ng/mL. The patients presented with fever, cough, dyspnea, anemia, and dyslipidemia. The radiological pattern was diffuse alveolointerstitial (n = 2), or bilateral basal interstitial (n = 2), or bilateral basal alveolar (n = 1). The cell count in the BAL was 95% to 99% macrophages. In two patients cultures for bacteria were positive: Hemophilus and Pseudomonas. Tests for fungi, mycobacteria, pneumocystis, and legionella, as well as PCR for CMV were all negative. Transbronchial biopsy yielded insufficient material in one patient and a deposit of fibrinoid material and nonnecrotizing granuloma in the other. Antibacterial therapy was started, three with cotrimoxazole and two with ganciclovir, with no response. The respiratory symptoms improved after withdrawal of sirolimus (mean, 2.4 +/- 1.5 days). The mean hospital stay was 19.8 +/- 14.1 days.

CONCLUSION

Pulmonary toxicity due to sirolimus should be included in the differential diagnosis of kidney transplant patients who display signs of interstitial pneumonia. Its diagnosis is difficult requiring exclusion of other pulmonary diseases. Resolution of the symptoms was quick after suspension of the drug.

Posttransplant Lymphoproliferative Disease: A Series of 23 Cases

Posttransplant lymphoproliferative disease (PTLD) is a rare but clinically important disorder due to its increasing incidence and its impact on renal function and the life of the patient. Between 1979 and 2005, this center performed 1614 kidney transplants, and 23 patients had PTLD. We undertook a retrospective study, analyzing risk factors, presentation, and evolution of the disorder. The most common clinical presentation was fever and adenopathy. All cases except one received calcineurin inhibitors, and nine were treated with monoclonal or polyclonal antibodies. Serology for Epstein Barr virus (EBV) was negative in nine patients at the time of transplant, and in five it became positive on diagnosis of PTLD. The predominant disorder was non-Hodgkin's lymphoma (NHL), either polymorphous (n = 11) or monomorphous (n = 7). The base therapy consisted of reducing or suspending calcineurin inhibitors and the addition of sirolimus and antivirals. Three patients received rituximab, and five chemotherapy. The disease progressed in 36% of the polymorphous NHL, in 67% of the monomorphous, and in 100% of the Hodgkin's lymphoma, whereas 10 patients had remission. Renal function worsened on diagnosis in eight patients, and the graft was infiltrated in five (confirmed histologically). Five patients lost the graft and 12 died; six due to infection and five due to PTLD. Survival was worse in the patients aged over 55 years. We conclude that in most cases EBV is positive on diagnosis of the PTLD, an age older than 55 years affords a poor prognosis, and lymphocyte infiltration of the graft is common, as is worsening renal function.

Variables affecting efficiency of molasses fermentation wastewater ozonation

The main operating variables affecting ozonation efficiencies of wastewater from beet molasses alcoholic fermentation have been studied. Semibatch experiments have been performed in order to analyze the influence of pH, bicarbonate ion, temperature and stirring rate on color and organic matter removals. The efficiencies were similar regardless of the pH, which indicates that direct reactions of ozone with wastewater organics were predominant to radical reactions. Gel permeation chromatography confirmed the reduction in the concentration of organics absorbing light at 475 nm after ozonation. The elimination of bicarbonate ion, strong inhibitor of hydroxyl radical reactions, yielded an improvement in both color and COD reduction efficiencies. Acidification for removing bicarbonate ions produced a shift of colored compounds to smaller molecular weights. The highest efficiencies were achieved at 40 degrees C. Color and COD reductions at 40 degrees C were about 90% and 37%, respectively. In no case, the percentage of TOC removed was higher than 10-15%. Stirring rate had a slightly positive effect during the first stage of the ozonation showing that mass transfer played a role only during the initial reaction phase when direct attack of ozone molecules to aromatic/olefinic structures of colored substances was the predominant pathway.

Plasma interferon-gamma, interleukin-10 and soluble markers of immune activation in infants with primary adenovirus (ADV) and respiratory syncytial virus (RSV) infection

Adenovirus (ADV) and respiratory syncytial virus (RSV) are etiological agents of acute respiratory tract infection in infants. Long-term prognosis of ADV infection includes severe lung damage, bronchiectasis and hyperlucent lung, while RSV infection is associated with development of recurrent wheezing and subsequent asthma. These differences may be related to differences in the primary immune responses elicited by these viruses. In this paper, we investigated the type of cytokine responses and the magnitude of immune activation in ADV and RSV infections in infants. We examined plasma concentrations of interferon-gamma (IFN-gamma), interleukin-10 (IL-10), soluble interleukin-2 receptor (sCD25) and soluble tumor necrosis factor receptor II (sTNFR-II) in previously healthy infants during the acute phase of primary ADV infection (n = 21) and RSV infection (n = 68), and in uninfected controls (n = 44). In ADV-infected infants, IFN-gamma plasma levels were significantly higher than those observed in RSV cases and the control group (p < 0.05). RSV cases did not show any differences in IFN-gamma plasma levels compared to the other groups. sCD25 levels were significantly higher in ADV- and RSV-infected infants than in controls (p < 0.0001), and higher in ADV than in RSV cases (p < 0.05). sTNFR-II levels were significantly higher in RSV- and ADV-infected infants than in controls (p < 0.0001, p < 0.05, respectively), and higher in RSV than in ADV infection (p < 0.05). No significant differences were observed in IL-10 plasma concentrations between the three groups. These results indicate that ADV and RSV infections in infants differ significantly with regard to the magnitude of production of interferon-gamma and soluble immune activation markers sCD25 and sTNFR-II. These immunological differences may be involved in the different clinical outcomes associated with these viral infections.

Clinical utility of anti-CCP antibodies in the differential diagnosis of elderly-onset rheumatoid arthritis and polymyalgia rheumatica

BACKGROUND

In a significant number of patients the differential diagnosis between elderly-onset rheumatoid arthritis (EORA) and polymyalgia rheumatica (PMR) is very difficult because of the lack of specific serum markers. Anti-cyclic citrullinated peptide antibodies (anti-CCP Abs) have recently been shown to be highly specific for rheumatoid arthritis (RA). This is the first study addressing the utility of these antibodies in the differential diagnosis between EORA and PMR.

METHODS

Serum samples from 57 EORA patients and 49 PMR patients were studied for the presence of anti-CCP Abs and rheumatoid factor (RF). As controls, samples from 41 RA patients (age at onset <60 yr) and 24 aged healthy subjects were analysed.

RESULTS

Sixty-five per cent of EORA patients had anti-CCP Abs, whereas none of the PMR patients or the aged healthy subjects was positive for those antibodies. Ten of the EORA patients started with polymyalgic symptoms and two of them were positive for anti-CCP Abs. Interestingly, there was a significant correlation between anti-CCP Abs and RF in EORA but not in young RA patients.

CONCLUSIONS

The presence of anti-CCP Abs in a patient with clinical symptoms of PMR must be interpreted as highly suggestive of EORA.

[Acute obstructive renal failure secondary to retroperitoneal mass]

The acute renal failure is a grave pathology, of rapid establishment and relatively frequent in the hospital environment. We can describe three etiological groupS, which are responsible for it, amongst which are emphasized the pre-renal reasons. The obstructive pathology, of minor incidence, increases with the age. It is described the case of a 67-yr-old patient who was admitted in the Nephrology Service because of abrupt decline of the renal function. Among the initial symptoms, he presented arterial hypertension (190/90) and preserved diuresis. Blood analysis: urea 199 mg/dl, creatinine 7.7 mg/dl, without proteinuria. Sonography reported a bilateral ureteral hydronephrosis with simple cyst of possible ischemic origin. In view of the absence of previous biochemical data of renal failure, we considered possible reasons which start with an acute pattern. In initial evaluation, pre-renal etiology was not seen (high blood pressure, right cardiac systole function). The absence of prostatic syndrome and sonography discovery did not justify a diagnosis of urinary tract obstruction. Finally, abdominal-pelvic scan showed a periaortic retroperitoneal mass which included both ureters and appeared to trigger the obstruction. Combined efforts were pursued with the Urology Service, which implanted a bilateral "double J" catheter and later operated surgically on the patient, carrying out an alternating ureterolysis of both ureters. The biopsy manifested a retroperitoneal fibrosis, and the renogram showed a residual renal function of 20% in the right kidney and 80% in the left kidney. Due to the failure of the previous measures and as a last therapeutic recourse when one year had passed from the diagnosis, a continuous regimen with tamoxifen (anti-estrogen drug) in dose of 20 mg/dl each 12 hours was started, which began a progressive remission in the size of the observed mass by scan (CT) and magnetic resonance (MR). The treatment was completed during 12 months and in this time, the levels of blood urea nitrogen and creatinine were reduced gradually too. Finally, at the end of the treatment, the magnetic resonance demonstrate the complete disappearance of the fibrosis.

Chemical oxidation of wastewater from molasses fermentation with ozone

Color removal from biologically pre-treated molasses wastewater by means of chemical oxidation with ozone has been investigated. Batch experiments have been performed in order to analyze the influence of ozone dosage and reaction time on color removal, molecular weight distribution and decolorization kinetics. Depending on the applied ozone dosage, color removal from 71% to 93% and COD reduction from 15% to 25% were reached after 30 min reaction time. TOC values remained constant throughout ozonation. Gel permeation chromatography corroborated that high molecular weight compounds, responsible for the brown color, were present in raw wastewater. UV spectral studies confirmed that these colored compounds were melanoidins. As a result of ozonation the concentration of chromophore groups decreased. Ozonation of synthetic melanoidin under the same experimental conditions provided similar color removal efficiencies. Pseudo-first order kinetics with respect to colored compounds were found.

Aprotinin mediated antioxidant effect in Cardiosurgery with mechanical cardiorespiratory support (CMCS)

BACKGROUND

Aprotinin has been used in cardiosurgery as a hemostatic agent. Considering the implication of oxygen reactive species and proteases in the pathogenesis of Systemic Inflammatory Response Syndrome, we hypothesized that aprotinin may exert an antioxidant effect. This work was designed to evaluate the antioxidant capacity of aprotinin in vitro and in vivo in child patients undergoing cardiosurgery with mechanical cardiorespiratory support.

METHODS

Colorimetric techniques and chemiluminiscent emission assays. A blind controlled clinical trial was performed with a control (G-1, n=14, without aprotinin) and treated with aprotinin (G-2, n=12) groups (both assessed by medical decision) of child patients undergoing cardiosurgery with mechanical cardiorespiratory support. Blood samples were taken at: T-0 (induction of anesthesia), T-1 (10 minutes after begining of perfusion), T-2 (5 minutes after anoxic heart arrest), T-3 (ending operation) and T-4 (24 hours after operation).

RESULTS

We proved that aprotinin has no hydroxyl radical, superoxide anion nor H2O2 scavenger capacity as well as its capacity for inhibiting in vitro activated-leukocyte chemiluminiscence. Malonildialdehyde levels were higher in G-1 than G-2 with the greatest difference at T-2 (7.2+/-3.6 nmol/ml in G-1 vs 4+/-1.65 in G-2). Phospholipase A2 activity showed a tendency of higher values in G-1 than G-2 although there was no statistical significance. Uric acid concentration was greater in G-2 at T-1, T-2, T-3 and T-4 than G-1 and catalase activity was higher in G-2 at T-0, T-2 and T-3 than G-1 with noteworthy difference only at 5 minutes after anoxic heart arrest. Low cardiac output, arrhythmias and sudden death in the early postoperative phase were less frequent in the treated group.

CONCLUSIONS

These results suggest that aprotinin exerts a primary antioxidant activity and its protective effects in cardiosurgery seem to be associated with reduction of systemic oxidative stress.

Biodegradation of phenolic industrial wastewater in a fluidized bed bioreactor with immobilized cells of Pseudomonas putida

The paper presents the main results obtained from the study of the biodegradation of phenolic industrial wastewaters by a pure culture of immobilized cells of Pseudomonas putida ATCC 17484. The experiments were carried out in batch and continuous mode. The maximum degradation capacity and the influence of the adaptation of the microorganism to the substrate were studied in batch mode. Industrial wastewater with a phenol concentration of 1000 mg/l was degraded when the microorganism was adapted to the toxic chemical. The presence in the wastewater of compounds other than phenol was noted and it was found that Pseudomonas putida was able to degrade these compounds. In continuous mode, a fluidized-bed bioreactor was operated and the influence of the organic loading rate on the removal efficiency of phenol was studied. The bioreactor showed phenol degradation efficiencies higher than 90%, even for a phenol loading rate of 0.5 g phenol/ld (corresponding to 0.54 g TOC/ld).

Effects of socioeconomic status on the obesity knowledge of adolescents from six Latin American cities

OBJECTIVE

To examine the effects of socioeconomic status (SES) on the obesity knowledge of adolescents in six Latin American cities.

DESIGN

Data were collected using an anonymous, self-administered questionnaire consisting of demographic questions and a 25-item multiple-choice obesity knowledge test. Test items were clustered under five topics: the fat and calorie content of foods and beverages; weight loss methods; energy expenditure; food preparation methods; and the relationship between obesity and health.

SUBJECTS

A total of 1272 ninth grade students from higher and lower SES families were recruited at schools in Buenos Aires, Argentina (n=195); Guatemala City, Guatemala (n=212); Havana, Cuba (n=213); Lima, Peru (n=218); Panama City, Panama (n=195); and Santiago, Chile (n=239).

RESULTS

Mean test scores reflected a low level of obesity knowledge among adolescents from higher and lower SES groups in all six cities. Nevertheless, a trend for higher scores emerged in favor of adolescents from wealthier families. This income effect persisted after controlling for gender and weight status. The weakest knowledge areas among youth from the higher SES groups were food preparation methods and the relationship between obesity and health while those for adolescents from the lower SES groups were the fat and calorie content of foods and beverages and the relationship between obesity and health. Classroom instruction about obesity was generally more available to students from the higher SES groups. The majority of adolescents from both SES groups were interested in learning more about weight loss methods, energy expenditure, and the fat and calorie content of foods and beverages. The topic of least interest was the relationship between obesity and health.

CONCLUSION

These preliminary findings suggest a need for more obesity education programs for adolescents, especially for those living in poverty.