Discovering oxidative potential (OP) drivers of atmospheric PM10, PM2.5, and PM1 simultaneously in North-Eastern Spain

Ambient particulate matter (PM) is a major contributor to air pollution, leading to adverse health effects on the human population. It has been suggested that the oxidative potential (OP, as a tracer of oxidative stress) of PM is a possible determinant of its health impact. In this study, samples of PM₁₀, PM_2.5, and PM₁ were collected roughly every four days from January 2018 until March 2019 at a Barcelona urban background site and Montseny rural background site in northeastern Spain. We determined the chemical composition of samples, allowing us to perform source apportionment using positive matrix factorization. The OP of PM was determined by measuring reactive oxygen species using dithiothreitol and ascorbic acid assays. Finally, to link the sources with the measured OP, both a Pearson's correlation and a multiple linear regression model were applied to the dataset. The results showed that in Barcelona, the OP of PM₁₀ was much higher than those of PM_2.5 and PM₁, whereas in Montseny results for all PM sizes were in the same range, but significantly lower than in Barcelona. In Barcelona, several anthropogenic sources were the main drivers of OP in PM₁₀ (Combustion + Road Dust + Heavy Oil + OC-rich) and PM_2.5 (Road Dust + Combustion). In contrast, PM₁ -associated OP was driven by Industry, with a much lower contribution to PM₁₀ and PM_2.5 mass. Meanwhile, Montseny exhibited no clear drivers for OP evolution, likely explaining the lack of a significant difference in OP between PM₁₀, PM_2.5, and PM₁. Overall, this study indicates that size fraction matters for OP, as a function of the environment typology. In an urban context, OP is driven by the PM₁₀ and PM₁ size fractions, whereas only the PM₁ fraction is involved in rural environments.

2011-2020 trends of urban and regional ammonia in and around Barcelona, NE Spain

It is well established that in environments where NH₃ abundance is limiting in secondary PM_2.5 generation, a reduction of NH₃ emissions can result in an important contribution to air quality control. However, as deduced from open data published by the European Environmental Agency, the availability of measurements of NH₃ concentrations is very scarce, with very few countries in Europe reporting data consistently for extensive periods, this being especially true for urban background sites. In this framework, simultaneous multi-site measurements were carried out in NE (Northeast) Spain from 2011 to 2020, using diffusion tubes. The highest NH₃ concentrations were recorded at the traffic site (5.3 μgm^-3 on average), followed by those measured at the urban background site (2.1 μgm^-3). Mean concentrations at the mountain site were 1.6 μgm^-3, while the lowest concentrations were recorded at the regional site (0.9 μgm^-3). This comparison highlights traffic emissions as an important source of NH₃. A statistically significant time trend of this pollutant was observed at the urban background site, increasing by 9.4% per year. A season-separated analysis also revealed a significant increasing trend at the mountain site during summer periods, probably related with increasing emissions from agricultural/livestock activities. These increases in NH₃ concentrations were hypothesized to be responsible for the lack of a decreasing trend of NO₃^- concentrations at the monitoring sites, in spite of a markedly reduction of NO₂ during the period, especially at the urban background. Thus, this would in turn affect the effectiveness of current action plans to abate fine aerosols, largely made up of secondary compounds. Actions to reduce NH₃ concentrations at urban backgrounds are challenging though, as predicting NH₃ is subjected to a high uncertainty and complexity due to its dependence on a variety of factors. This complexity was clearly indicated by the application of a decision tree algorithm to find the parameters better predicting NH₃ at the urban background under study. O₃, NO, NO₂, CO, SO₂ and OM + EC concentrations, together with meteorological indicators, were used as independent variables, obtaining no combination of parameters evidently able to predict significant differences in NH₃ concentrations, with a coefficient of determination between real and predicted measurements lower than 0.50. This emphasizes the need for highly temporally and spatially resolved NH₃ measurements for an accurate design of abatement actions.

Quantitative analysis of the natural history of prolidase deficiency: description of 17 families and systematic review of published cases

PURPOSE

Prolidase deficiency is a rare inborn error of metabolism causing ulcers and other skin disorders, splenomegaly, developmental delay, and recurrent infections. Most of the literature is constituted of isolated case reports. We aim to provide a quantitative description of the natural history of the condition by describing 19 affected individuals and reviewing the literature.

METHODS

Nineteen patients were phenotyped per local institutional procedures. A systematic review following PRISMA criteria identified 132 articles describing 161 patients. Main outcome analyses were performed for manifestation frequency, diagnostic delay, overall survival, symptom-free survival, and ulcer-free survival.

RESULTS

Our cohort presented a wide variability of severity. Autoimmune disorders were found in 6/19, including Crohn disease, systemic lupus erythematosus, and arthritis. Another immune finding was hemophagocytic lymphohistiocytosis (HLH). Half of published patients were symptomatic by age 4 and had a delayed diagnosis (mean delay 11.6 years). Ulcers were present initially in only 30% of cases, with a median age of onset at 12 years old.

CONCLUSION

Prolidase deficiency has a broad range of manifestations. Symptoms at onset may be nonspecific, likely contributing to the diagnostic delay. Testing for this disorder should be considered in any child with unexplained autoimmunity, lower extremity ulcers, splenomegaly, or HLH.

African dust and air quality over Spain: Is it only dust that matters?

The 2001-2016 contribution of African dust outbreaks to ambient regional background PM10 and PM2.5 levels over Spain, as well as changes induced in the PMx composition over NE Spain in 2009-2016, were investigated. A clear decrease in PMx dust contributions from the Canary Islands to N Iberia was found. A parallel increase in the PM2.5/PM10 ratio (30% in the Canary Islands to 57% in NW Iberia) was evidenced, probably due to size segregation and the larger relative contribution of the local PMx with increasing distance from Africa. PM1-10 and PM2.5-10 measured in Barcelona during African dust outbreaks (ADOs) were 43-46% higher compared to non-ADO days. The continental background contribution prevailed in terms of both PM1-10 and PM2.5-10 during ADO days (62 and 69%, respectively, and 31 and 27% for non-ADO days). The relative contributions of Al₂O₃/Fe₂O₃/CaO to PMx fraction showed that Al₂O₃ is a suitable tracer for African dust in our context; while CaO at the urban site is clearly affected by local resuspension, construction and road dust, and Fe₂O₃ by dust from vehicle brake discs. The results also provide evidence that PM increases during ADOs are caused not only by the mineral dust load, but by an increased accumulation of locally emitted or co-transported anthropogenic pollutants as compared with non-ADO days. Possible causes for this accumulation are discussed. We recommend that further epidemiological studies should explore independently the potential effects of mineral dust and the anthropogenic PM during ADOs, because, at least over SW Europe, not only mineral dust affects the air quality during African dust episodes.

Vertical and horizontal fall-off of black carbon and NO2 within urban blocks

While exposure to traffic pollutants significantly decreases with distance from the curb, very dense urban architectures hamper such dispersion. Moreover, the building height reduces significantly the dispersion of pollutants. We have investigated the horizontal variability of Black Carbon (BC) and the vertical variability of NO₂ and BC within the urban blocks. Increasing the distance from road BC concentrations decreased following an exponential curve reaching halving distances at 25 m (median), although with a wide variability among sites. Street canyons showed sharper fall-offs than open roads or roads next to a park. Urban background concentrations were achieved at 67 m distance on average, with higher distances found for more trafficked roads. Vertical fall-off of BC was less pronounced than the horizontal one since pollutants homogenize quickly vertically after rush traffic hours. Even shallower vertical fall-offs were found for NO₂. For both pollutants, background concentrations were never reached within the building height. A street canyon effect was also found exacerbating concentrations at the lowest floors of the leeward side of the road. These inputs can be useful for assessing population exposure, air quality policies, urban planning and for models validation.

Monitoring the impact of desert dust outbreaks for air quality for health studies

We review the major features of desert dust outbreaks that are relevant to the assessment of dust impacts upon human health. Our ultimate goal is to provide scientific guidance for the acquisition of relevant population exposure information for epidemiological studies tackling the short and long term health effects of desert dust. We first describe the source regions and the typical levels of dust particles in regions close and far away from the source areas, along with their size, composition, and bio-aerosol load. We then describe the processes by which dust may become mixed with anthropogenic particulate matter (PM) and/or alter its load in receptor areas. Short term health effects are found during desert dust episodes in different regions of the world, but in a number of cases the results differ when it comes to associate the effects to the bulk PM, the desert dust-PM, or non-desert dust-PM. These differences are likely due to the different monitoring strategies applied in the epidemiological studies, and to the differences on atmospheric and emission (natural and anthropogenic) patterns of desert dust around the world. We finally propose methods to allow the discrimination of health effects by PM fraction during dust outbreaks, and a strategy to implement desert dust alert and monitoring systems for health studies and air quality management.

Dry eye is matched by increased intrasubject variability in tear osmolarity as confirmed by machine learning approach

OBJECTIVE

Because of high variability, tear film osmolarity measures have been questioned in dry eye assessment. Understanding the origin of such variability would aid data interpretation. This study aims to evaluate osmolarity variability in a clinical setting.

MATERIAL AND METHODS

Twenty dry eyes and 20 control patients were evaluated. Three consecutive osmolarity measurements per eye at 5min intervals were obtained. Variability was represented by the difference between both extreme readings per eye. Machine learning techniques were used to quantify discrimination capacity of tear osmolarity for dry eye.

RESULTS

Mean osmolarities in the control and dry eye groups were 295.1±7.3mOsm/L and 300.6±11.2mOsm/L, respectively (P=.004). Osmolarity variabilities were 7.5±3.6mOsm/L and 16.7±11.9mOsm/L, for the control and dry eye groups, respectively (P<.001). Based on osmolarity, a logistic classifier showed an 85% classification accuracy.

CONCLUSIONS

In the clinical setting, both mean osmolarity and osmolarity variability in the dry eye group were significantly higher than in the control group. Machine learning techniques showed good classification accuracy. It is concluded that higher variability of tear osmolarity is a dry eye feature.

Evaluation of fine organic mixtures for treatment of acid mine drainage in sulfidogenic reactors

The performance of passive biochemical reactors in acid mine drainage (AMD) treatment could be enhanced by using fine organic substrates in new reactor designs, such as diffusive exchange reactors. This work evaluated the effect of fine cellulosic components in organic mixtures and of enrichment with inoculum, on sulfate and metals removal in discontinuous cultures for three types of synthetic AMD. The cellulosic substrates evaluated were sawdust, microcrystalline cellulose, and forestry cellulose fibers, supplemented with cow manure and leaf compost. Using microcrystalline cellulose and forestry cellulose fibers with the less concentrated AMD, high sulfate reduction rates (73 mg/L-d and 58.2 mg/L-d, respectively) were achieved. Correspondingly, iron concentrations were reduced by 69% and 86.6%. Based on their higher sulfate reducing capacity, cellulose fibers obtained as fiber boards from a local kraft pulp mill were selected for treating a synthetic AMD with a high copper concentration (273 mg/L) and pH 4.94. In batch culture, low sulfate reducing activity (13.10 mg/L-d) was only observed at the highest substrate/AMD ratio (0.5:10) tested. Results show that the use of forestry cellulose fibers in reactive mixtures supplemented with inoculum could be an alternative for optimization of diffusive exchange reactors for AMD treatment.

Accuracy of the Diagnosis of Allergic Reactions in the Emergency Department

BACKGROUND AND OBJECTIVE

Suspicion of an acute allergic reaction is a common reason for attending the emergency department (ED). However, there are few comparisons between the initial diagnosis of suspected allergic reaction made in the ED with the definitive diagnosis made subsequently in the allergy department (AD). Objective: To compare details of the initial diagnosis made in the ED relating to allergy with the final diagnosis made in the AD.

METHODS

Patients attending the ED of 2 hospitals with suspected allergic reactions were prospectively enrolled based on key words. A certified allergy specialist reviewed the ED records of these patients and, if these were suggestive of an allergic reaction, the patients were scheduled for further evaluation at the allergy clinic.

RESULTS

In total, 2000 patients were enrolled between April 2013 and October 2015. Of these, 1333 passed the initial assessment and underwent further evaluation. Of the 1333 patients, 528 underwent an allergological study, and 206 were confirmed as being allergic. With respect to drug allergy, nonsteroidal anti-inflammatory drugs were the most common triggers, followed by β-lactams; in food allergy, plant-based foods were the most common. Only 16.4% of patients confirmed as having anaphylaxis in the AD were initially diagnosed with the condition in the ED.

CONCLUSION

Of the 528 patients who finally underwent the full allergological study, fewer than half were confirmed as allergic. Moreover, anaphylaxis appears to be underdiagnosed in the ED. Better communication between the ED and the AD is necessary to improve the diagnosis and management of these patients.

Local allergic rhinitis: Implications for management

A significant proportion of rhinitis patients without systemic IgE-sensitisation tested by skin prick test and serum allergen-specific IgE (sIgE) display nasal reactivity upon nasal allergen provocation test (NAPT). This disease phenotype has been termed local allergic rhinitis (LAR). LAR is an underdiagnosed entity affecting children and adults from different parts of the world, with moderate-to-severe symptoms, impairment of quality of life and rapid progression to symptom worsening. LAR is a stable phenotype and not merely an initial state of AR. Allergic rhinitis and LAR share many clinical features including a positive NAPT response, markers of type 2 nasal inflammation including sIgE in nasal secretions and a significant rate of asthma development. LAR should be considered as a differential diagnosis in those subjects of any age with symptoms suggestive of AR but no evidence of systemic atopy. Although LAR pathophysiology is partially unknown, in some patients sIgE can be demonstrated directly in the nasal secretions and/or indirectly via positive responses in basophil activation test (BAT). LAR can coexist with other rhinitis phenotypes, especially AR. The diagnosis currently relies on the positivity of NAPT to a single or multiple allergens. NAPT has high sensitivity, specificity and reproducibility, and it is considered the gold standard. BAT and the measurement of nasal sIgE can also contribute to LAR diagnosis. LAR patients benefit from the same therapeutic strategies than AR individuals, including the avoidance of allergen exposure and the pharmacotherapy. Moreover, several recent studies support the effectiveness and safety of allergen immunotherapy for LAR, which opens a window of treatment opportunity in these patients.

Genotypic tropism testing of proviral DNA to guide maraviroc initiation in aviraemic subjects: 48-week analysis of results from the PROTEST study

OBJECTIVES

Maraviroc (MVC) is a suitable drug for aviraemic subjects on antiretroviral treatment (ART) developing toxicity. Its prescription requires prior tropism testing. It is unknown if proviral DNA genotypic tropism testing is reliable for guiding MVC initiation in aviraemic subjects, so this study was carried out to address this issue.

METHODS

PROTEST was a phase 4, prospective, single-arm clinical trial carried out in 24 HIV care centres in Spain. MVC-naïve HIV-1-infected patients with HIV-1 RNA < 50 copies/mL on stable ART during the previous 6 months who required an ART change because of toxicity and who had R5 HIV, as determined by proviral DNA genotypic tropism testing, initiated MVC with two nucleoside reverse transcriptase inhibitors (NRTIs) and were followed for 48 weeks. Virological failure was defined as two consecutive viral load measurements > 50 copies/mL.

RESULTS

Tropism results were available for 141 of 175 (80.6%) subjects screened: 60% had R5 and 85% of these (n = 74) were finally included in the study. Previous ART included protease inhibitors (PIs) in 62% of subjects, nonnucleoside reverse transcriptase inhibitors (NNRTIs) in 36%, and integrase inhibitors (INIs) in 2%. Main reasons for treatment change were dyslipidaemia (42%), gastrointestinal symptoms (22%) and liver toxicity (15%). MVC was given alongside tenofovir (TDF)/emtricitabine (FTC) (54%) and abacavir (ABC)/lamivudine (3TC) (40%) in most patients. Eighty-four per cent of patients maintained a viral load < 50 copies/mL to week 48, whereas 16% discontinued treatment: two withdrew informed consent, one had an R5 to X4 shift between screening and baseline, one was lost to follow-up, one developed an adverse event (rash), two died from non-study-related causes, and five developed protocol-defined virological failure.

CONCLUSIONS

Initiation of MVC plus two NRTIs in aviraemic subjects based on genotypic tropism testing of proviral HIV-1 DNA is associated with low rates of virological failure for up to 1 year.

Fibrous Histiocytoma-like Spindle-Cell Proliferation in the Nipple After Body-Piercing

We report the case of a 19-year-old pregnant woman who presented with a nipple tumor. The lesion consisted in a spindle-cell proliferation with histologic features similar to those of fibrous histiocytoma, with a highly vascularized stroma. Although it showed low mitotic activity, scattered marked atypical cells with prominent nucleoli were identified, thus raising concern about the benign nature of the tumor. Immunohistochemical evaluation revealed that the spindle cells were diffusely positive for vimentin, focally positive for CD68, and negative for all the other tested antibodies. The patient had a total excision of the lesion and she is free of disease after 30 months. To our knowledge this is the first reported case of a lesion of this type in the nipple after body-piercing.

Anti-inflammatory effect of dialysable leucocyte extract in a rat model of osteoarthritis: histopathological and molecular characterization

OBJECTIVES

To evaluate the effect of dialysable leucocyte extract (DLE) on pro- and anti-inflammatory profiles in a rat model of osteoarthritis (OA).

METHOD

Forty-eight male Wistar rats were divided into three groups: normal rats without treatment, OA rats treated with placebo, and OA rats treated with DLE. After treatment, the animals were killed to obtain cartilage for histological analysis and to determine the expression of pro- and anti-inflammatory cytokines by reverse transcription multiplex polymerase chain reaction (RT-MPCR) and immunohistofluorescence analyses.

RESULTS

Histological analysis revealed that OA cartilage from rats treated with DLE displayed similar characteristics to non-OA cartilage from the control group. The OA cartilage treated with placebo showed alterations in the cellular architecture and in chondrocyte cluster formation. Analysis of cytokine expression by RT-MPCR showed that OA cartilage from DLE-treated rats expressed platelet-derived growth factor (PDGF), interferon (IFN)-γ, and fibroblast growth factor (FGF)-2, similar to non-OA cartilage from the control group. However, OA cartilage from rats treated with placebo expressed interleukin (IL)-1, PDGF, and I kappa B (IκB). Confocal immunodetection of FGF-2, PDGF, and non-phosphorylated IκB showed that they were distributed in the cytoplasm of most chondrocytes in OA cartilage from DLE-treated rats whereas no nuclear factor kappa B (NF-κB) expression was observed in the nuclei. Instead, in OA cartilage from the placebo group, only weak FGF-2 staining was observed, PDGF and IκB were not detected, and NF-κB was strongly observed in both cytoplasm and nuclei.

CONCLUSIONS

Our findings suggest that DLE treatment modifies the OA process, promoting the expression of anti-inflammatory cytokines and diminishing the inflammatory effects, avoiding the nuclear translocation of NF-κB in chondrocytes.

Secondary organic aerosol origin in an urban environment: influence of biogenic and fuel combustion precursors

Source contributions of organic aerosol (OA) are still not fully understood, especially in terms of quantitative distinction between secondary OA formed from anthropogenic precursors vs. that formed from natural precursors. In order to investigate the OA origin, a field campaign was carried out in Barcelona in summer 2013, including two periods characterized by low and high traffic conditions. Volatile organic compound (VOC) concentrations were higher during the second period, especially aromatic hydrocarbons related to traffic emissions, which showed a marked daily cycle peaking during traffic rush hours, similarly to black carbon (BC) concentrations. Biogenic VOC (BVOC) concentrations showed only minor changes from the low to the high traffic period, and their intra-day variability was related to temperature and solar radiation cycles, although a decrease was observed for monoterpenes during the day. The organic carbon (OC) concentrations increased from the first to the second period, and the fraction of non-fossil OC as determined by ¹⁴C analysis increased from 43% to 54% of the total OC. The combination of ¹⁴C analysis and Aerosol Chemical Speciation Monitor (ACSM) OA source apportionment showed that the fossil OC was mainly secondary (>70%) except for the last sample, when the fossil secondary OC only represented 51% of the total fossil OC. The fraction of non-fossil secondary OC increased from 37% of total secondary OC for the first sample to 60% for the last sample. This enhanced formation of non-fossil secondary OA (SOA) could be attributed to the reaction of BVOC precursors with NO_x emitted from road traffic (or from its nocturnal derivative nitrate that enhances night-time semi-volatile oxygenated OA (SV-OOA)), since NO₂ concentrations increased from 19 to 42 μg m⁻³ from the first to the last sample.

Forkhead box protein 3(+) regulatory T cells and Helios(+) subset in perinatally acquired HIV

Forkhead box protein 3 (FoxP3)(+) regulatory T cells (Tregs ) are important not only in regulating the development of autoimmune conditions, but also in chronic infectious diseases. Given their cardinal function in suppressing immune activation, research has focused upon whether they play a detrimental role in chronic infections, particularly HIV. While the role of Tregs in HIV has been investigated intensively, it remains an unresolved topic. However, it is generally accepted that Tregs are susceptible to HIV infection and are preferentially preserved over conventional CD4(+) T cells. It is unknown whether the peripheral-induced or the thymic-derived Tregs are more susceptible to HIV cytotoxicity. It has been recognized that Tregs can be segregated into two subsets based on Helios expression, with the vast majority being Helios(+) . This study examines the impact of HIV infection on total Tregs and their Helios subsets in a perinatal-acquired HIV-infected paediatric population. The finding indicates a selective expansion or survival of Tregs in association with CD4 depletion and increased viraemia. The Helios(+) and Helios(-) subsets within Tregs appear to be equally affected. However, the Helios(+) Tregs seem to be more preserved in patients with low CD4(+)  ≤ 25% and detectable plasma HIV RNA >20 copies/ml. In this group, the frequencies of Tregs are increased, but their numbers appear insufficient to restrain immune activation. In conclusion, our findings suggest that both Helios subsets of Tregs are susceptible to HIV infection and are preferentially preserved compared to conventional CD4(+) T cells.

2001-2012 trends on air quality in Spain

This study aims at interpreting the 2001-2012 trends of major air pollutants in Spain, with a major focus on evaluating their relationship with those of the national emission inventories (NEI) and policy actions. Marked downward concentration trends were evidenced for PM10, PM2.5 and CO. Concentrations of NO2 and NOx also declined but in a lesser proportion at rural and traffic sites. At rural sites O3 has been kept constant, whereas it clearly increased at urban and industrial sites. Comparison of the air quality trends and major inflection points with those from NEIs, the National Energy Consumption and the calendar of the implementation of major policy actions allowed us to clearly identify major benefits of European directives on power generation and industrial sources (such as the Large Combustion Plants and the Integrated Pollution Prevention and Control Directives). This, together with a sharp 2007-2008 decrease of coal consumption has probably caused the marked parallel decline of SO2, NOx and for PM2.5 concentrations. Also the effect of the EURO 4 and 5 vehicle emission standards on decreasing emissions of PM and CO from vehicles is noticeable. The smooth decline in NO2-NOx levels is mostly attributed to the low efficiency of EURO 4 and 5 standards in reducing real life urban driving NO2 emissions. The low NOx decrease together with the complexity of the reactions of O3 formation is responsible for the constant O3 concentrations, or even the urban increase. The financial crisis has also contributed to the decrease of the ambient concentration of pollutants; however this caused a major reduction of the primary energy consumption from 2008 to 2009, and not from 2007 to 2008 when ambient air PM and SO2 sharply decreased. The meteorological influence was characterized by a 2008-2012 period favorable to the dispersion of pollutants when compared to the 2001-2007.

A FEM-based method to determine the complex material properties of piezoelectric disks

Numerical simulations allow modeling piezoelectric devices and ultrasonic transducers. However, the accuracy in the results is limited by the precise knowledge of the elastic, dielectric and piezoelectric properties of the piezoelectric material. To introduce the energy losses, these properties can be represented by complex numbers, where the real part of the model essentially determines the resonance frequencies and the imaginary part determines the amplitude of each resonant mode. In this work, a method based on the Finite Element Method (FEM) is modified to obtain the imaginary material properties of piezoelectric disks. The material properties are determined from the electrical impedance curve of the disk, which is measured by an impedance analyzer. The method consists in obtaining the material properties that minimize the error between experimental and numerical impedance curves over a wide range of frequencies. The proposed methodology starts with a sensitivity analysis of each parameter, determining the influence of each parameter over a set of resonant modes. Sensitivity results are used to implement a preliminary algorithm approaching the solution in order to avoid the search to be trapped into a local minimum. The method is applied to determine the material properties of a Pz27 disk sample from Ferroperm. The obtained properties are used to calculate the electrical impedance curve of the disk with a Finite Element algorithm, which is compared with the experimental electrical impedance curve. Additionally, the results were validated by comparing the numerical displacement profile with the displacements measured by a laser Doppler vibrometer. The comparison between the numerical and experimental results shows excellent agreement for both electrical impedance curve and for the displacement profile over the disk surface. The agreement between numerical and experimental displacement profiles shows that, although only the electrical impedance curve is considered in the adjustment procedure, the obtained material properties allow simulating the displacement amplitude accurately.

Influence of lipid composition and membrane curvature on fluorescence and solvent relaxation kinetics in unilamellar vesicles

Time-resolved fluorescence on unilamellar vesicles shows that increasing amounts of anionic, natural lipid lead to a larger increase in polarity close to the headgroups than in the hydrophobic core of the bilayer. The region close to the headgroups is less polar in vesicles containing phosphatic acid rather than phosphatidylserine. A greater membrane curvature increases the mobility of the hydrated headgroups.

SiO2 coating effects in the magnetic anisotropy of Fe3-xO4 nanoparticles suitable for bio-applications

We present radio frequency transverse susceptibility (TS) measurements on oleic acid-coated and SiO2-coated Fe3-xO4 magnetite nanoparticles. The effects of the type of coating on the interparticle interactions and magnetic anisotropy are evaluated for two different particle sizes in powder samples. On the one hand, SiO2 coating reduces the interparticle interactions as compared to oleic acid coating, the reduction being more effective for 5 nm than for 14 nm diameter particles. On the other hand, the magnetic anisotropy field at low temperature is lower than 1 kOe in all cases and independent of the coating used. Our results are relevant concerning applications in biomedicine, since the SiO2 coating renders 5 and 14 nm hydrophilic particles with very limited agglomeration, low anisotropy, and superparamagnetic behavior at room temperature. The TS technique also allows us to discriminate the influence on the anisotropy field of interparticle interactions from that of the thermal fluctuations.

[Thyroid carcinoma in pediatrics: a 30-year follow-up]

INTRODUCTION

The thyroid tumours are infrequent neoplasms of presentation in paediatric. The object of this study was to value therapeutic evolution and the survival throughout 30 years.

MATERIALS

28 cases with diagnosis of thyroid carcinoma. Were reviewed from 1978 to 2008. Were the variables to study: epidemiologists, methods used diagnostic, type of histology, later treatment and survival to 300 months to the treatment. We like considered significant p <0.05.

RESULTS

73.1% of the cases were of feminine sex. The average age was 12.3 years (1.6 to 19). The ultrasound was asked for the test more (78.5%). The RET mutation associated appear in three cases to MEN. The histology type to papillary was most frequent (50%). The total thyroidectomy (TT) was the surgery practice more (67.9%). The radioiodine (RI) was used in 46.4% of the cases. The substitute hormonal therapy was used 27 patients. 89.29% of the were series after 300 months free of disease.

CONCLUSIONS

The treatment of the series these are hundreds throughout 30 years, but when valuing our experience we include / understand that: 1) the TT with selective lymphatic dissection, 2) it in the RI cases with positive to the body tracking and/or of factors of risk and 3) the substitute hormonal therapy, is the at the moment best offer alternatives to than we can these paediatric patients and prolong the survival in adult its age.

Size fractionate particulate matter, vehicle traffic, and case-specific daily mortality in Barcelona, Spain

Recent epidemiological research suggests that short-term effects of particle matter (PM) in urban areas may preferentially be driven by fine fractions. Questions remain concerning the adversehealth effects of coarse particles generated by noncombustion, traffic-related processes and the mechanism of action of PM. Using a time-stratified case-crossover design, we investigated the association between three independent size fractions, coarse (PM10-2.5), intermodal (PM2.5-1), and very fine PMs (PM1), and three health outcomes, respiratory, cardiovascular, and cerebrovascular mortality in Barcelona, Spain, during the period of March 2003-December 2005. Using existing data, we examined the chemical composition of each fraction to explore the effects of PM from different sources and the mechanisms of action. We found that increased levels of PM, and PM10-2.5 were associated with increased levels of cardiovascular and cerebrovascular mortality at lag 1 and lag 2. At lag 1, the odds ratio (OR) for a 1 microg/m3 increase in PM1 was 1.028 [95% confidence interval (CI), 1.000-1.058] for cardiovascular mortality and 1.063 (95% CI, 1.004-1.124) for cerebrovascular mortality. At lag 1, the odds ratio per a 10 microg/ m3 increase of PM10-2.5 was 1.059 (95% CI, 1.026-1.094) for cardiovascular mortality and 1.098 (95% CI, 1.030-1.171) for cerebrovascular mortality. Association with respiratory mortality was only detected for PM2.5-1 at lag 2 (OR, 1.206 per a 10 microg/ m3 increase; 95% CI, 1.028-1.416). Chemical composition data showed that PM in Barcelona was generated in a large proportion by vehicle traffic. Vehicle traffic PM, generated by combustion and noncombustion processes, should be considered in air pollution mitigation strategies in urban areas.

Thyrotropin levels and their relationship with cardiovascular risk factors in the island of Gran Canaria, Spain. Implications of lowering the upper reference limit of thyrotropin stimulating hormone

OBJECTIVE

To characterize the cardiovascular risk profile of subjects with high and normal-high concentrations of serum TSH in a sample of adult Spanish subjects from the island of Gran Canaria.

DESIGN

Cross-sectional population-based study.

SUBJECTS

After excluding 28 individuals on current treatment with levothyroxine and 9 others with TSH levels below the range of normality (0.3-4.9 mU/l), 704 randomly selected subjects (412 women; age range: 30-82 yr) belonging to the Telde Study were assessed.

MEASUREMENTS

Participants underwent physical examination and fasting blood analyses to determinate TSH, serum lipids, homocysteine, fibrinogen, von Willebrand factor, plasminogen activator inhibitor- 1, C-reactive protein, and insulin.

RESULTS

Twenty-nine participants had serum TSH concentrations above the normal range of normality. Among all the studied variables, only female sex and diastolic blood pressure were significantly associated with TSH levels > or =5 mU/l in a multivariate logistic regression analysis. If the upper normal limit of TSH was reduced up to 2.4 mU/l, an additional group of 106 subjects would be considered to have elevated TSH levels. A serum TSH > or =2.5 mU/l was positive and independently associated with female sex, body mass index, total cholesterol, and homocysteine, and negatively associated with smoking.

CONCLUSIONS

Although the impact of serum TSH levels on cardiovascular risk cannot be established from these findings, TSH values within the upper part of the usually accepted normal range were demonstrated to be associated with well-recognized risk factors for cardiovascular disease.

[Side effects and patients expectations after vestibular tests]

OBJECTIVE

Patients satisfaction and side effects assessment after vestibular tests.

MATERIALS AND METHODS

Questionnaires were sent to 150 patients after vestibular testing in 2006. Forty-two questionnaires were sent back to us. On each questionnaire there were 5 questions regarding patient expectations, 4 questions about side effects after vestibular tests and one question was related to follow-up medical attention.

RESULTS

Most of the patients think that the delay between clinical consultation and vestibular test was not too long. Information patients received beforehand regarding vestibular tests aim, duration, possible side effects and diagnostic expectations are good enough for most of the patients. However patient's assessment of the informed consent document and location of vestibular tests is diverse. The vast majority of patients feel "very important" to receive information about vestibular tests results on the same day. For most of the subjects caloric test is the most disconfortable tests. In the following days, more than half of the subjects feel vestibular symptoms. The most frequent suggestion we received from patients is to give them a phone calls after vestibular tests.

CONCLUSION

It is worth mentioning the importance of informing the patient about vestibular test results upon completion. Our aim is to make some changes on the informed consent document given to patients and to make a phone call to patients after vestibular tests.

Interpretation of the variability of levels of regional background aerosols in the Western Mediterranean

Results on interpretation of the variability of regional background PM levels in the Western Mediterranean basin (WMB) are presented. Mean PM levels recorded at Montseny, MSY (North-Eastern Spain) in the 2002--2007 period reached 17, 13 and 11 microg/m3 of PM10, PM2.5 and PM1, respectively. The daily evolution of PM levels is regulated by the breeze circulation (mountain and sea breezes). PM levels are lower at the rural sites at night owing to the nocturnal drainage flows and to the lowering of the mixing layer height below the MSY high. These nocturnal low levels allowed us to estimate the continental background PM levels. At midday, the atmospheric pollutants accumulated in the pre-coastal depression are transported upwards by the breeze, increasing PM levels. Maximum PM10 levels were recorded in summer, and February--March and November, and minimum values in the rest of the year coinciding with the highest frequency of Atlantic advection. PM peak episodes attributed to Saharan dust outbreaks were recorded in summer and February-March. In addition, anticyclonic situations (February--March and November) may impact in elevated rural areas by increasing hourly levels of PM1 up to 75 microg/m3. This scenario induces the stagnation of pollutants in the pre-coastal depression. Solar radiation activates mountain winds, transporting polluted air masses from the valleys to elevated areas resulting in an increase of fine PM levels in areas outside the boundary layer. A significant decrease in PM annual means (40% and 34% for the entire monitoring period, 7 microgPM10/m3 and 5 microgPM2.5/m3) was recorded at MSY between 2002 and 2007. There appears to be no single cause behind these trends. This could partially be ascribed to the varying frequency and intensity of Saharan dust episodes, but also to large-scale meteorological processes or cycles, and/or to local or meso-scale processes such as nearby anthropogenic emission sources.

Surface anisotropy broadening of the energy barrier distribution in magnetic nanoparticles

The effect of surface anisotropy on the distribution of energy barriers in magnetic fine particles of nanometer size is discussed within the framework of the Tln(t/τ(0)) scaling approach. The comparison between the distributions of the anisotropy energy of the particle cores, calculated by multiplying the volume distribution by the core anisotropy, and of the total anisotropy energy, deduced by deriving the master curve of the magnetic relaxation with respect to the scaling variable Tln(t/τ(0)), enables the determination of the surface anisotropy as a function of the particle size. We show that the contribution of the particle surface to the total anisotropy energy can be well described by a size-independent value of the surface energy per unit area which permits the superimposition of the distributions corresponding to the particle core and effective anisotropy energies. The method is applied to a ferrofluid composed of non-interacting Fe(3-x)O(4) particles of 4.9 nm average size and x about 0.07. Even though the size distribution is quite narrow in this system, a relatively small value of the effective surface anisotropy constant K(s) = 2.9 × 10(-2) erg cm(-2) gives rise to a dramatic broadening of the total energy distribution. The reliability of the average value of the effective anisotropy constant, deduced from magnetic relaxation data, is verified by comparing it to that obtained from the analysis of the shift of the ac susceptibility peaks as a function of the frequency.

[Capsule endoscopy interpretation: the role of physician extenders]

BACKGROUND AND AIMS

capsule endoscopy (CE) allows for a new era in small-bowel examination. Nevertheless, physicians time for CE-interpretation remains longer than desirable. Alternative strategies to physicians have not been widely investigated. The aim of this study was to evaluate the accuracy of physician extenders in CE-interpretation.

MATERIAL AND METHODS

one CE-experienced gastroenterologist and two physician extenders reviewed independently 20 CE-procedures. Each reader was blinded to the findings of their colleagues. A consensus formed by the readers and a second CE-experienced gastroenterologist was used as gold standard. Number, type and location of images selected, character of CE-exams and their relationship with indications were recorded. Gastric emptying time (GEt), small-bowel transit time (SBTt) and time spent by readers were also noted.

RESULTS

sensitivity and specificity for "overall" lesions was 79 and 99% for the gastroenterologist; 86 and 43% for the nurse; and 80 and 57% for the resident. All 34 "major" lesions considered by consensus were found by the readers. Agreement between consensus and readers for images classification and procedures interpretation was good to excellent (? from 0.55 to 1). No significant differences were found in the GEt and SBTt obtained by consensus and readers. The gastroenterologist was faster than physician extenders (mean time spent was 51.9 +/- 13.5 minutes versus 62.2 +/- 19 and 60.9 +/- 17.1 for nurse and resident, respectively; p < 0.05).

CONCLUSIONS

physician extenders could be the perfect complement to gastroenterologists for CE-interpretation but gastroenterologists should supervise their findings. Future cost-efficacy analyses are required to assess the benefits of this alternative.

Hearing loss and vestibular function correlation in Menière's disease patients

OBJECTIVES

To analyse the correlation between vestibular dysfunction and hearing level of patients diagnosed with Menière's disease.

METHODS

Retrospective study on the correlation between hearing level and unilateral weakness in 100 Menière's disease patients. In order assess the effect of disease severity in such correlation, the study group included 50 patients who subsequently were treated with oral medication and 50 who later received intratympanic gentamicin to control their symptoms. Audiogram and caloric tests were performed before beginning both of the treatments. Patients were classified according to the AAO-HNS guidelines. Handicap was assessed with the Functional Level of the AAO-HNS and the Dizziness Handicap Inventory.

RESULTS

No correlation was found between pure tone average and canal paresis neither when patients were analysed as a whole nor when correlation was controlled for the treatment installed afterwards. Nevertheless, when they were grouped by hearing loss AAO-HNS stages, we found a greater canal paresis in those with a higher hearing loss (groups 3 and 4).

CONCLUSION

No correlation was found between hearing loss and canal paresis of patients diagnosed with Menière's disease. However patients with a higher amount of hearing damage have a tendency to abnormal caloric results.

Recognizing a mother's voice in the persistent vegetative state

We studied an 8-year-old boy after a near-drowning left him in a vegetative state (VS) for 4 years before the study. Findings fulfilled all clinical criteria for the diagnosis of VS. The purpose of this study was to investigate whether there was significant differential activation of the brain in response to hearing his mother's voice compared with the voices of unknown women. The data were assessed using quantitative electric tomography (QEEGt), a technique that combines anatomical information of the brain by MRI with EEG patterns to estimate the sources of the EEG within the brain. We found significant differences for EEG frequencies from 14-58 Hz, with a peak at 33.2 Hz (gamma band). The 3D reconstruction showed that these statistical differences were localized in the lateral and posterior regions of the left hemisphere. No significant differences were found between unknown women vs. basal conditions. These results demonstrate recognition of the mother's voice and indicate high-level residual linguistic processing in a patient meeting clinical criteria for VS. These findings launch new ethical and practical implications for the management of VS patients.

Immunohistochemically proven cytomegalovirus end-organ disease in solid organ transplant patients: clinical features and usefulness of conventional diagnostic tests

We studied the main clinical features, outcome, and laboratory parameters in a group of solid organ transplant (SOT) patients with immunohistochemically proven cytomegalovirus (CMV) disease. Confirmed CMV cases were obtained through databases. Demographics, clinical data, transplantation type, immunosuppressive regimens, donor and recipient CMV serostatus, therapy, outcome and laboratory results, pp65 antigenemia, and qualitative polymerase chain reaction (PCR) for CMV were analyzed. From 1995 to 2004, 31 cases with complete medical records were identified. Disease appeared between 24 and 2538 days after transplantation but most cases presented in the first 100 days. Gastrointestinal CMV disease was the most frequent form (71%), while thrombocytopenia was present in 50% of cases, and leukopenia was less common (35.5%). CMV pp65 antigenemia was positive in 58% of patients, but its sensitivity increased to 71% if performed during the first 6 months. A qualitative CMV PCR technique gave similar results during this period (71.4%). Most patients were treated with intravenous ganciclovir (n=25; 80.6%). In 4 cases (19.4%), use of foscarnet alone or a sequential regimen with ganciclovir-foscarnet was deemed necessary. Surgical procedures were necessary in 5 patients (16%). The death rate reached 13%. CMV end-organ disease can be a life-threatening infection in SOT patients. Gastrointestinal disease was the most frequent end-organ disease. CMV antigen detection is best suited for the early period after transplantation.

Two-factor design for coagulant/flocculant doses effect for solid-liquid separation of dairy manure

Screened dairy manure, with a total solids content equal to 34.7 g TS l(-1), was subjected to a coagulation-flocculation treatment using FeCl, as coagulant and a medium cationic polyacrylamide (MCP1). The effect of changing doses of the additives (FeCl3 and MCP1) on the properties of supernatant fractions was studied by means of design of response surface using "Statgraphics Plus 3.0" program. The results showed that the values of concentrations found in supernatants obtained after settling of the flocs for two of the dependent variables studied, filtrate chemical oxygen demand (CODf) and total organic carbon (TOC), were significantly influenced by both the FeCl3 and MCP1 doses at an error lower than 5%. The values of concentrations of the remaining variables studied (TS, VS, CODt, CODvfa) were significantly influenced only by the MCP1 dose at an error lower than 5%. The predictive model obtained the best satisfactory parameters for TOC supernatant's concentration (R2=0.980, F-ratio = 438.89 (p-value < 0.05)) and the worse for VS (R2 = 0.783, F-ratio = 33.43 (p-value < 0.05)).

[Postural analysis of the test "timed-up-and-go" in patients with vertigo]

INTRODUCTION AND OBJECTIVES

To characterize and analyze the "Timed-up-and-go" test in non-fallers patients with peripheral vertigo. To assess if turning to the side of the lesion induces a more intense instability.

MATERIAL AND METHODS

The test was performed after carefully explanation to the patient who was allowed to do some attempts. Postural measurements were the angle and angular speed of trunk sway in roll and pitch. It was done with a special device adapted to the trunk with two sensors specially built for that purpose.

CONCLUSIONS

Dizzy, non-fallers patients perform this test in a period of time considered as normal. Canal paresis influences in roll trunk sway when the patient performs the TUG only when turning to the normal side.

Efecto acústico inmediato de la fístula coclear en el cobaya

INTRODUCTION AND OBJECTIVES

To Evaluate objectively the effect that cochleostomy has in the cochlea as well as the exposition of the estria vascularis, through acoustic otoemissions immediatly after surgery.

MATERIAL AND METHODS

Submandibular approach to the guinea pig's middle ear and cochlea. Triming of the timpanic and vestibular first turns and wide exposition of the estria vascularis in the first and second turns. Study of cochlear function through acoustic otoemissions of distortion products.

CONCLUSIONS

Guinea Pig is a perfect experimentation animal for surgical work when monitoring functional state of the cochlea. Its acoustic response is similar to the one found in other mammals thoug its response is lower than that reported in other papers. The lack of intracochlear manipulation ensures the lower decrease hearing loss deterioration regarding the findings in the different methods of studying the acousting distortion.

RESULTS

There is a decrease of amplitud in the audiograms of distortion for specific frequencies (4 and 6 KHz), located tonotopically near the cochleostomies carried out in the first turn (at the level of scala vestigularis and timpanic). Approadring the cochlea without intracochlear manipulation does not modify greathy the results of audiograms of distortion neither the growth slopes of the response. A lateral approach of the estric vascularis minimising the aggression to labrynth did not cause a significant acoustic deterioration.

Native valve endocarditis due to Candida glabrata treated without valvular replacement: a potential role for caspofungin in the induction and maintenance treatment

Conventional antifungal therapy for fungal endocarditis has been associated with a poor cure rate. Therefore, combined medical and surgical therapy has been recommended. However, new potent antifungal agents, such as echinocandins, could increase the medical options and, in some cases, avoid the need for surgery. We report a case of Candida endocarditis treated successfully without valve replacement with intravenous liposomal amphotericin B (total dose, 4 g) and intravenous caspofungin (a 100-mg loading dose followed by 50 mg per day for 8 weeks) as induction therapy and intravenous caspofungin (100 mg 3 times per week for 12 weeks) as maintenance therapy.

Primary meningococcal conjunctivitis

Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis. One case of primary meningococcal conjunctivitis in a healthy 6-year-old boy is reported. The patient was initially treated with a topical instillation of polymyxin B, neomycin and gramicidin in ophthalmic solution, and this was followed by systemic rifampin once the diagnosis had been established. No ocular or systemic complications developed.

Activity of aphids associated with lettuce and broccoli in Spain and their efficiency as vectors of Lettuce mosaic virus

This research sought to identify the aphid virus vector species associated with lettuce and broccoli crops in Spain, and to determine their population dynamics and ability to transmit Lettuce mosaic virus (LMV). Green tile traps and Moericke yellow water-pan traps were used to monitor aphid flights during the spring and autumn growing seasons of 2001. Aphid species feeding on lettuce were counted weekly. The transmission efficiencies of LMV were determined for the aphid species caught most frequently. The Moericke traps generally caught more aphid species than the tile trap, but the latter was the most suitable to estimate flight activity of species involved in virus spread. Spring aphid catches indicated that the main aphid species landing on lettuce in the regions of Madrid and Murcia was Hyperomyzus lactucae, but Brachycaudus helichrysi was also abundant in both regions. In broccoli in the Navarra region, the most abundant species in spring were Aphis fabae, B. helichrysi and H. lactucae. In autumn-sown crops, the main species landing on lettuce in the Madrid region were Hyadaphis coriandri and Aphis spiraecola. In Murcia, A. spiraecola and Myzus persicae were the most abundant, while in Navarra, Therioaphis trifolii, and various Aphis spp. were the most numerous landing on broccoli. The main aphid species colonising lettuce was Nasonovia ribisnigri, but other less abundant colonising species were Aulacorthum solani and Macrosiphum euphorbiae. The most efficient vectors of LMV were M. persicae, Aphis gossypii and M. euphorbiae, while A. fabae and H. lactucae transmitted with low efficiency, and Rhopalosiphum padi and N. ribisnigri did not transmit. Occurrence of LMV epidemics in central Spain in relation to aphid flights and the role of weeds as virus reservoirs is discussed.

The births of five Spanish babies from cryopreserved donated oocytes

BACKGROUND

The technique of freezing oocytes is still not widely used. Reasons cited for this include the technique's low efficacy and the risk of aneuploidy. However, the introduction of technical changes (the type and concentration of cryoprotective substances; slow freezing and rapid thawing; and fertilization by ICSI) has led to improved results. We present four pregnancies obtained using mature oocytes (in metaphase II) that had been frozen and thawed. The oocytes were donated by young women who were not patients.

METHODS

The frozen oocytes (n = 88) came from seven donors aged 18-25 years. The metaphase II oocytes, morphologically normal in appearance, were denuded of their cumulus-corona complex. The cryoprotective freezing solution contained 1,2-propanediol (1.5 mol/l) and sucrose (0.3 mol/l). Freezing was slow and thawing rapid. The oocytes were fertilized by ICSI.

RESULTS

Seventy-nine of the 88 thawed oocytes survived (89.8%); 58 were fertilized (73.4% of all those microinjected); and 26 were transferred (44.8% of all those fertilized). Four pregnancies were produced after seven transfers (57.1%). Five children were born from four pregnancies.

CONCLUSIONS

With the freezing/thawing technique used, oocyte survival was high ( approximately 90%). The pregnancy rate with frozen oocytes was similar to that obtained using fresh oocytes from donors ( approximately 50%).

Duodenal switch: an effective therapy for morbid obesity--intermediate results

BACKGROUND

The duodenal switch (DS) is a variant of the biliopancreatic diversion (BPD), with a vertical subtotal gastrectomy and pylorus preservation.

METHODS

DS was used to treat morbid obesity in 125 patients, with mean BMI 50, with 65% of the patients super obese (SO). Patients have been followed for an intermediate period.

RESULTS

The percentage of excess weight loss (%EWL) was > 70% at 1 year, and reached 81.4% at 5 years when 97% of the patients had a %EWL > 50%. Comorbidities were cured or improved in all patients.

CONCLUSION

DS was very effective for the treatment of the morbid obesity in the SO patients.

Auditory brainstem implantation in primates: lessons for human surgery and application

We report on the surgical technique for surface electro-auditory prosthesis (EAP) implantation, pathological changes occurring at the cochlear nucleus complex (CNC), and its relation with electrical stimulation. Fourteen Macaca fascicularis were operated upon for a translabyrinthine bilateral auditory neurectomy, and simultaneous unilateral EAP implantation. Six animals were not stimulated, and the remaining eight were connected to an external active device. Stimulation was planned for 1000 hours. Biotolerance to the materials was adequate without significant reactions in the CNC surface, but an ependymal reaction. Lesions attributed to surgical trauma were also found. Two animals being stimulated could not complete the planned course due to cable break or EAP extrusion. One stimulated animal developed an asymptomatic brainstem abscess. A good knowledge of CNC topography is required to avoid surgical trauma. Externally connected devices may facilitate extrusion of the EAP or ascending infections.